Active NPI
Raina Sushil Gupta, MD
- Neurology Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 125052600
- Practice address
- 9110 College Pointe CT
Fort Myers, FL 33919-3244 - Phone
- (239) 208-2212
- Fax
- (239) 208-3994
- NPI assigned
- Aug 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD60932592 | WA | |
| Neurology Physician | 2084N0400X | TM00813 | TX | |
| Neurology Physician | 2084N0400X | 58906 | TN | |
| Neurology Physician | 2084N0400X | MD191892 | OR | |
| Neurology Physician | 2084N0400X | 35.135507 | OH | |
| Neurology Physician | 2084N0400X | 297932 | NY | |
| Neurology Physician | 2084N0400X | 19584 | NH | |
| Neurology Physician | 2084N0400X | 15689 | ND | |
| Neurology Physician | 2084N0400X | 83797 | GA | |
| Neurology Physician | 2084N0400X | ME139296 | FL | |
| Neurology Physician | 2084N0400X | 4301116846 | MI | |
| Neurology Physician | 2084N0400X | 125052600 | IL | Primary |
Addresses
Primary practice location
9110 College Pointe CT
Fort Myers, FL 33919-3244
Mailing address
3000 N. Halsted St.
Suite 703
Chicago, IL 60657
Phone (773) 296-6666
Other practice location 1
172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 882-3000
Other practice location 2
3000 N. Halsted St.
Suite 703
Chicago, IL 60657
Phone (773) 296-6666
Other practice location 3
630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3118715 | Medicaid | NH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rgupta705005@direct.ketteringhealth.org | ||
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WA, SC, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Sleep Medicine
- Education
- University of Louisville School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2538 W Patterson Ave
Chicago, IL 60618-6077
Phone (312) 498-8927
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME139296 | FL | MD | Neurology Physician |
| 83797 | GA | MD | Neurology Physician |
| 125052600 | IL | MD | Neurology Physician |
| 58906 | TN | MD | Neurology Physician |
| MD60932592 | WA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upson County Hospital Inc | Family Medicine | Current | Accepting new patients |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Columbus Ambulatory Healthcare Services, Inc. | Family Medicine | Current | Accepting new patients |
| Columbus Ambulatory Healthcare Services, Inc. | Family Medicine | Current | Accepting new patients |
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Sleepologie Health and Wellness LLC | Neurology | Current | Accepting new patients |
| Piedmont Athens Hospitalist Physicians LLC | Current | Accepting new patients | |
| Upson County Hospital Inc | Neurology | Current | Accepting new patients |
| Piedmont Athens Specialty Care LLC | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Advocate North Side Health Network | Past | Accepting new patients |
Locations
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000
710 Center St
Columbus, GA 31901
Phone (706) 571-1000
1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120
801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
Interoperability endpoints
- sleepologie@shawl-il.direct.office.nextgen.com
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 11
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.
-
- Neurology Physician
- Chicago, IL
- NPI 1376291849
-
- Family Medicine Physician
- Columbus, GA
- NPI 1790733244
-
- Clinic/Center
- Vancouver, WA
- NPI 1356357784
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1578079000
-
- Family Medicine Physician
- Phenix City, AL
- NPI 1699240531
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
-
- Clinic/Center
- Chicago, IL
- NPI 1780788323
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Cardiovascular Disease Physician
- Athens, GA
- NPI 1184130627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1366698482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 N. HALSTED ST.",
"address_2": "SUITE 703",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60657",
"telephone_number": "773-296-6666",
"fax_number": "713-296-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9110 COLLEGE POINTE CT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339193244",
"telephone_number": "239-208-2212",
"fax_number": "239-208-3994"
}
],
"practiceLocations": [
{
"address_1": "172 Kinsley St",
"address_purpose": "LOCATION",
"city": "Nashua",
"state": "NH",
"postal_code": "030603648",
"country_code": "US",
"telephone_number": "603-882-3000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3000 N. Halsted St.",
"address_2": "Suite 703",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60657",
"country_code": "US",
"telephone_number": "773-296-6666",
"fax_number": "713-296-9999",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "630 Eaton Ave",
"address_purpose": "LOCATION",
"city": "Hamilton",
"state": "OH",
"postal_code": "450132767",
"country_code": "US",
"telephone_number": "513-867-2000",
"fax_number": "513-867-2119",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUPTA",
"first_name": "RAINA",
"middle_name": "SUSHIL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-08",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WA",
"license": "MD60932592",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TX",
"license": "TM00813",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "58906",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OR",
"license": "MD191892",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OH",
"license": "35.135507",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "297932",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NH",
"license": "19584",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "ND",
"license": "15689",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "GA",
"license": "83797",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME139296",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "4301116846",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "125052600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3118715",
"state": "NH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rgupta705005@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "630 Eaton Ave",
"city": "Hamilton",
"state": "OH",
"country_code": "US",
"postal_code": "450132767",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
"affiliation": "N",
"address_1": "630 Eaton Ave",
"city": "Hamilton",
"state": "OH",
"country_code": "US",
"postal_code": "450132767",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.