Individual provider Active NPI

Rakesh Kumar Gupta, M.D.

  • Internal Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1366495780
Registry record updated Jan 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
218280 Issued in NY
Practice address
10555 62ND Dr
Suite 1- H
Forest Hills, NY 11375-1101
Phone
(718) 592-2626
Fax
(718) 592-6910
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 218280 NY Primary

Addresses

Primary practice location

10555 62ND Dr
Suite 1- H
Forest Hills, NY 11375-1101

Mailing address

11312 Jewel Ave
Forest Hills, NY 11375-3953
Phone (718) 592-2626

Other identifiers 4

IdentifierTypeStateIssuer
02098593MedicaidNY
2589768-PPOOtherNYGHI
2795246OtherNMOXFORD
2382S1OtherNYEMPIRE BLUE CROSS/BLUE SH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051104000388 NY Practitioner - Internal Medicine 5092733592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
May accept Medicare assignment
Group practices
Dr Rakesh Gupta-Dr Meenu Gupta Medical PCGroup PAC ID 4486672979, 2 clinicians
Lefferts Medical Associates PCGroup PAC ID 6305839150, 17 clinicians

Practice addresses (Care Compare)

10555 62ND Dr
Suite 1H
Forest Hills, NY 11375-1109
Phone (646) 400-2332

26619 Union Tpke
New Hyde Park, NY 11040-1426
Phone (718) 347-0434

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218280NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lefferts Medical Associates PC Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
Instant Medical Care, PC Internal Medicine PastSince Apr 11, 2021 Accepting new patients
New York Community Hospital of Brooklyn, Inc. Internal Medicine Past Accepting new patients
Lifeco Medical, P.C. Past Accepting new patients
Queens Medical Office, P.C. Internal Medicine Past Accepting new patients

Locations

10555 62nd Dr
Ste 1H
Forest Hills, NY 11375
Phone (718) 592-2626

26619 Union Tpke
New Hyde Park, NY 11040
Phone (718) 347-0434

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325376000000",
    "number": "1366495780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11312 JEWEL AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753953",
            "telephone_number": "718-592-2626",
            "fax_number": "718-592-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 62ND DR",
            "address_2": "SUITE 1- H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751101",
            "telephone_number": "718-592-2626",
            "fax_number": "718-592-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAKESH",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "218280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02098593",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2589768-PPO",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "2795246",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS/BLUE SH",
            "identifier": "2382S1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.