Individual provider Active NPI

Siddharth Gupta, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1346972460
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD21171 Issued in RI
Practice address
164 Summit Ave
Providence, RI 02906-2853
Phone
(401) 793-4489
Fax
(401) 793-4047
NPI assigned
Jun 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD21171 RI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

164 Summit Ave
Providence, RI 02906-2853

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220722000571 MS Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4981085982

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1346972460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-4489",
            "fax_number": "401-793-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SIDDHARTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-28",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD21171",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.