Active NPI
Pratishtha Gupta, MD
- Hospitalist Physician
- Syracuse, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 302366
- Practice address
- 750 E Adams St
Syracuse, NY 13210-2306 - Phone
- (315) 464-5910
- Fax
- (315) 464-1937
- NPI assigned
- Aug 1, 2014
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | C1-0013111 | DE | |
| Hospitalist Physician | 208M00000X | C1-0013111 | DE | |
| Hospitalist Physician | 208M00000X | MD175833 | OR | |
| Hospitalist Physician | 208M00000X | 302366 | NY | Primary |
Addresses
Primary practice location
750 E Adams St
Syracuse, NY 13210-2306
Mailing address
251 Salina Meadows Pkwy Ste 100
Syracuse, NY 13212-4516
Phone (315) 464-2014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0013111 | DE | MD | Hospitalist Physician |
| MD175833 | OR | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silverton Health | Current | Accepting new patients | |
| Legacy Clinics LLC | Internal Medicine | Current | Accepting new patients |
| Silverton Health | Current | Accepting new patients | |
| Silverton Health | Current | Accepting new patients |
Locations
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667
342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Silverton, OR
- NPI 1669424354
-
- Specialist
- Silverton, OR
- NPI 1093828006
-
- Clinic/Center
- Molalla, OR
- NPI 1861116055
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Clinic/Center
- Portland, OR
- NPI 1679597108
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1417365503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 SALINA MEADOWS PKWY STE 100",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132124516",
"telephone_number": "315-464-2014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 E ADAMS ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132102306",
"telephone_number": "315-464-5910",
"fax_number": "315-464-1937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "PRATISHTHA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-01",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DE",
"license": "C1-0013111",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "DE",
"license": "C1-0013111",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "OR",
"license": "MD175833",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "302366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.