Individual provider Active NPI

Priyanka Gupta, M.D

  • Hospitalist Physician
  • Antioch, CA
National Provider Identifier
1457697971
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A138055 Issued in CA
Practice address
3901 Lone Tree Way
Antioch, CA 94509-6200
Phone
(925) 756-1192
Fax
(925) 756-1869
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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 A138055 CA
Hospitalist Physician 208M00000X A138055 CA Primary

Addresses

Primary practice location

3901 Lone Tree Way
Antioch, CA 94509-6200

Mailing address

3687 Mt Diablo Blvd
Lafayette, CA 94549-3717
Phone (916) 854-6975

Other identifiers 1

IdentifierTypeStateIssuer
A138055OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151208000591 CA Practitioner - Internal Medicine 8325268600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3901 Lone Tree Way
Antioch, CA 94509-6200
Phone (925) 756-1192

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138055CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients
Sutter Delta Medical Center Past Accepting new patients

Locations

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3687 Mt Diablo Blvd
Ste 200
Lafayette, CA 94549
Phone (510) 204-6660

12 Camino Encinas
Orinda, CA 94563
Phone (510) 204-8180

795 El Camino Real
#1112
Palo Alto, CA 94301

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.

Hospital & facility affiliations 1

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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1457697971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 MT DIABLO BLVD",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493717",
            "telephone_number": "916-854-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096200",
            "telephone_number": "925-756-1192",
            "fax_number": "925-756-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRIYANKA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A138055",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A138055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A138055",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.