Individual provider Active NPI

Madhu N Gupta, MD

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1457466419
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
45745 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
#135
Milwaukee, WI 53215-3693
Phone
(414) 385-8600
Fax
(414) 385-8668
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125043241 IL
Internal Medicine Physician 207R00000X 45745 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
#135
Milwaukee, WI 53215-3693

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
34505800MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mgupta23144@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040709001286 WI Practitioner - Internal Medicine 9335127927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aamg Reach PLLCGroup PAC ID 5597133264, 52 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125043241ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2004 Accepting new patients
Aamg Reach PLLC Internal Medicine CurrentSince Sep 20, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2004 Accepting new patients
Aurora Health Care Metro, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215
Phone (414) 385-1277

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

2801 W Kinnickinnic River Pkwy
Ste 135
Milwaukee, WI 53215
Phone (414) 385-8600

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 W Kinnickinnic River Pkwy
#135
Milwaukee, WI 53215
Phone (414) 385-8600

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

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 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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1457466419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "#135",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153693",
            "telephone_number": "414-385-8600",
            "fax_number": "414-385-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MADHU",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125043241",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "45745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34505800",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgupta23144@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "#135",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy",
            "address_2": "#135",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.