Gopal N. Gupta, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036128866 Issued in IL

Practice address

2160 S 1St Ave
Fahey Center, BLDG 54
Maywood, IL 60153-3328

Phone

(708) 216-5098

Fax

(708) 126-1699

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Urology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
• Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center, Inc.

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878

  Urology

  Medicare reassignment Care Compare group NPD
• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954
  Medicare reassignment NPD
• Loyola University Medical Center

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Saint Joseph Regional Medical Center, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gottlieb Memorial Hospital

  • General Acute Care Hospital
  • Melrose Park, IL
  • NPI 1831170232
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1326182015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "FAHEY CENTER, BLDG 54",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5098",
            "fax_number": "708-126-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "FAHEY CENTER, BLDG 54",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-5098",
            "fax_number": "708-126-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "GOPAL",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036128866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggupta43253@direct.luhs.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2160 S 1st Ave",
            "address_2": "Fahey Center, Bldg 54",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allisonn Elizabeth Grupski, PHD
• Daniel Gryzlo, MD
• Taj Gubatanga, CRNA
• Cynthia Gunsteen, RN
• Amit Gupta, M.D.
• Rachit Gupta, MD
• Trisha Sameer Gupte, MD
• Dana Gustafson, DPM
• Allen N Gustin Jr., MD
• Cheyenne Guy, MD

• Urology Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.