Mohinder K. Gupta, M.D., Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

35041004 Issued in OH

Legal business name

MOHINDER K. GUPTA, M.D., INC.

Practice address

21 Sugarbush CT
Ashland, OH 44805-9737

Phone

(419) 289-6466

Fax

(419) 281-4067

NPI assigned

Feb 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohinder K Gupta, M.D.

Title

President

Phone

(419) 289-6466

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Sugarbush Eye and Laser Centre Doing business as

Tax ID family

Mohinder K Gupta MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mohinder K. Gupta, M.D., Inc.

  • Specialist
  • Mansfield, OH
  • NPI 1578578217
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1306973136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SUGARBUSH CT",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448059737",
            "telephone_number": "419-289-6466",
            "fax_number": "419-281-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SUGARBUSH CT",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448059737",
            "telephone_number": "419-289-6466",
            "fax_number": "419-281-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHINDER K. GUPTA, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "MOHINDER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-289-6466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35041004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "0460513",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2059561",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "2322025",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2682726",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0343711",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "MO9287132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sugarbush Eye and Laser Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Miller
• Jessica Lynn Miller
• Breeaunna M. Mitchell, MA, LPC
• Mobile Medical Diagnostic Services of Ohio
• Sharon Anita Moherman Long, LSW
• Jeffrey L Montague
• Vicki L Montesano, PCCS
• Amy Moore
• Jason Richard Ellsworth Moore, LSW
• Jayden Renee Moore

• Specialist in Ashland, OH
• Providers in Ashland, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.