Individual provider Active NPI

Nina Gupta, MD

  • Pulmonary Disease Physician
  • Aventura, FL
National Provider Identifier
1366451213
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
186054 Issued in NY
Practice address
20200 W. Dixie Hwy Ste 808
Aventura, FL 33180
Phone
(305) 934-9149
Fax
(718) 897-1002
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 186054 NY Primary

Addresses

Primary practice location

20200 W. Dixie Hwy Ste 808
Aventura, FL 33180

Mailing address

17885 Collins Ave Unit 3603
Sunny Isles, FL 33160
Phone (305) 916-1454

Other identifiers 1

IdentifierTypeStateIssuer
01642433MedicaidNY

Other names 1

  • Mridula Gupta Noori Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2017 through Jan 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
186054NYMDPulmonary Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1366451213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17885 COLLINS AVE UNIT 3603",
            "city": "SUNNY ISLES",
            "state": "FL",
            "postal_code": "33160",
            "telephone_number": "305-916-1454",
            "fax_number": "718-897-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20200 W. DIXIE HWY STE 808",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-934-9149",
            "fax_number": "718-897-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "186054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01642433",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MRIDULA",
            "last_name": "NOORI",
            "middle_name": "GUPTA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.