Individual provider Active NPI

Puneet K Gupta, M.D.

  • Interventional Cardiology Physician
  • Canton, OH
National Provider Identifier
1427498674
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
54828 Issued in KY
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 363-6293
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 256292 MA
Cardiovascular Disease Physician 207RC0000X 2017004299 MO
Student in an Organized Health Care Education/Training Program 390200000X 57.248725 OH
Interventional Cardiology Physician 207RI0011X 54828 KY Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

2600 Sixth St SW
Department of Cardiology
Canton, OH 44710
Phone (330) 363-6293

Other practice location 1

800 Hospital Dr
Madisonville, KY 42431-1658
Phone (270) 326-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210603002578 KY Practitioner - Cardiovascular Disease (Cardiology) 7719272210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Deaconess Medical Group IncGroup PAC ID 6103220330, 241 clinicians

Practice addresses (Care Compare)

800 Hospital Dr
FL 1
Madisonville, KY 42431-1658
Phone (270) 326-3800

Hospital & facility affiliations

  • Baptist Health Deaconess Madisonville Hospital, Madisonville, KY, CCN 180093
  • Jennie Stuart Medical Center Hospital, Hopkinsville, KY, CCN 180051
  • Caldwell Medical Center Hospital, Princeton, KY, CCN 181322
  • Trigg County Hospital Hospital, Cadiz, KY, CCN 181304
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256292MAMDInternal Medicine Physician
2017004299MOMDCardiovascular Disease Physician
57.248725OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Deaconess Medical Group Inc Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2021 Accepting new patients
Baptist Health Medical Group Inc Cardiovascular Disease CurrentSince Jul 1, 2021 Accepting new patients
Baptist Health Deaconess Medical Group Inc Internal Medicine CurrentSince Sep 1, 2021 Accepting new patients
Baptist Health Madisonville Inc Past Accepting new patients

Locations

500 Clinic Dr
Hopkinsville, KY 42240
Phone (270) 707-3300

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

800 Hospital Dr
Ste 1
Madisonville, KY 42431

800 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3800

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

800 Hospital Dr
Fl 2
Madisonville, KY 42431
Phone (270) 326-3900

800 Hospital Dr
Fl 1
Madisonville, KY 42431
Phone (270) 326-3800

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1427498674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "address_2": "DEPARTMENT OF CARDIOLOGY",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44710",
            "telephone_number": "330-363-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-6293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "424311658",
            "country_code": "US",
            "telephone_number": "270-326-3800",
            "fax_number": "270-326-3805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PUNEET",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "256292",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2017004299",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.248725",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "54828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.