Individual provider Active NPI

Punit K Gupta, MD

  • Infectious Disease Physician
  • Cedar Grove, NJ
National Provider Identifier
1336118975
Registry record updated Jun 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MA072171 Issued in NJ
Practice address
388 Pompton Ave
Ste 4
Cedar Grove, NJ 07009-1814
Phone
(973) 779-5879
Fax
(973) 239-4267
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MA072171 NJ Primary

Addresses

Primary practice location

388 Pompton Ave
Ste 4
Cedar Grove, NJ 07009-1814

Mailing address

388 Pompton Ave
Ste 4
Cedar Grove, NJ 07009-1814
Phone (973) 779-5879

Other identifiers 1

IdentifierTypeStateIssuer
0036323MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040820000955 NJ Practitioner - Infectious DiseasePractitioner - Internal Medicine 4082688585 Practice locations: Cedar Grove, NJ

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Rutgers New Jersey Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

388 Pompton Ave
Suite 4
Cedar Grove, NJ 07009-1814
Phone (973) 910-8010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA072171NJMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vijay K. Gupta, M.D. PastSince Apr 25, 2007 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pgupta198087@ahs.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496534400000",
    "number": "1336118975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 POMPTON AVE",
            "address_2": "STE 4",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091814",
            "telephone_number": "973-779-5879",
            "fax_number": "973-239-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 POMPTON AVE",
            "address_2": "STE 4",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091814",
            "telephone_number": "973-779-5879",
            "fax_number": "973-239-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PUNIT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2017-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA072171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036323",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Grove, NJ

Sources for this page

Verify at the official NPI Registry.