Organization Active NPI

Associated Physicians Group PLC

  • Internal Medicine Physician
  • Berkley, MI
National Provider Identifier
1447794102
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ASSOCIATED PHYSICIANS GROUP PLC
Practice address
1695 W 12 Mile Rd
Suite 200
Berkley, MI 48072-2182
Phone
(248) 548-9090
Fax
(248) 548-8462
NPI assigned
Dec 14, 2016
Last updated
Dec 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Authorized official

Name
Nelum Gupta, MD
Title
Owner
Phone
(248) 548-9090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1695 W 12 Mile Rd
Suite 200
Berkley, MI 48072-2182

Mailing address

1695 W 12 Mile Rd
Suite 200
Berkley, MI 48072-2182
Phone (248) 548-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170113000392 MI Part B Supplier - Clinic/Group Practice 7113209875 Receives reassigned benefits from 7 practitioners
Practice locations: Berkley, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2125235Associated Physicians Group PLC1695 W 12 Mile Road Suite 200, Berkley, MI 48072Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1447794102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 W 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722182",
            "telephone_number": "248-548-9090",
            "fax_number": "248-548-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 W 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722182",
            "telephone_number": "248-548-9090",
            "fax_number": "248-548-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED PHYSICIANS GROUP PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "NELUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-548-9090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.