NPIMap

Individual provider Active NPI

Shakunmala Gupta, M.D.

  • Internal Medicine Physician
  • Columbia, MD
National Provider Identifier
1437255338
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0053150 Issued in MD
Practice address
9650 Santiago Rd Ste 6
Columbia, MD 21045-3960
Phone
(410) 992-7004
Fax
(410) 992-1657
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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 D0053150 MD Primary

Addresses

Primary practice location

9650 Santiago Rd Ste 6
Columbia, MD 21045-3960

Mailing address

PO Box 6303
Ellicott City, MD 21042-0303
Phone (410) 992-7004

Other identifiers 1

IdentifierTypeStateIssuer
241500300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322000170 MD Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2062467186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Care LLCGroup PAC ID 4486819703, 3 clinicians
Kauser and Tanveer MD PAGroup PAC ID 0648249060, 2 clinicians

Practice addresses (Care Compare)

6334 Cedar LN
Columbia, MD 21044-3898
Phone 4108322520100

9650 Santiago Rd
Suite 6
Columbia, MD 21045-3960
Phone (410) 992-7004

Hospital & facility affiliations

  • Gilchrist Hospice Care, Inc Hospice, Hunt Valley, MD, CCN 211526
  • Bridginglife, Inc. Hospice, Westminster, MD, CCN 211522
  • Encore at Turf Valley Nursing home, Ellicott City, MD, CCN 215355
  • Lorien Health Systems - Columbia Nursing home, Columbia, MD, CCN 215112
  • Mount Airy Nursing and Rehab Center Nursing home, Mount Airy, MD, CCN 215268

Merit-based Incentive Payment System (MIPS)

Final score
27.67 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
92.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0053150MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kauser and Tanveer MD PA CurrentSince Jun 1, 2004 Accepting new patients
Health First Medical Care LLC CurrentSince Jul 9, 2012 Accepting new patients
Lorien Nursing & Rehab Ctr Inc. Past Accepting new patients
Health First Medical Care LLC Past Accepting new patients
Old National Leasing Co., LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Lorien Howard, Inc. Past Accepting new patients
Health First Medical Care LLC Past Accepting new patients
Hospital Physician Services, LLLP Internal Medicine Past Accepting new patients
Health First Medical Care LLC Past Accepting new patients

Locations

6334 Cedar Ln
Columbia, MD 21044
Phone (301) 596-6483

9650 Santiago Rd
Ste 110
Columbia, MD 21045
Phone (410) 884-3600

9650 Santiago Rd
Ste 6
Columbia, MD 21045
Phone 4108322520100

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pleasant View Healthcare CenterMount Airy, MD, CCN 215268 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2022
Jun 5, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 5

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1437255338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6303",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210420303",
            "telephone_number": "410-992-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 SANTIAGO RD STE 6",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453960",
            "telephone_number": "410-992-7004",
            "fax_number": "410-992-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SHAKUNMALA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0053150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241500300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.