Individual provider Active NPI

Nitin Gupta, MD

  • Pediatrics Physician
  • Dobbs Ferry, NY
National Provider Identifier
1477790061
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
253963 Issued in NY
Practice address
18 Ashford Ave Ste 3W
Dobbs Ferry, NY 10522-1824
Phone
(914) 330-8445
Fax
(914) 330-8446
NPI assigned
Jan 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 253963 NY Primary

Addresses

Primary practice location

18 Ashford Ave Ste 3W
Dobbs Ferry, NY 10522-1824

Mailing address

18 Ashford Ave Ste 3W
Dobbs Ferry, NY 10522-1824
Phone (914) 330-8445

Other identifiers 1

IdentifierTypeStateIssuer
03524834MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130314000189 NY Practitioner - Pediatric Medicine 6901041227 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253963NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rivertowns Pediatrics PC Pediatrics CurrentSince May 16, 2021 Accepting new patients
Boston Children's Health Physicians, LLP Pediatrics CurrentSince Apr 1, 2016 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Apr 1, 2016 Accepting new patients
TBHC Pediatric Services PC Pediatrics PastSince Apr 13, 2025 Accepting new patients

Locations

18 Ashford Ave
Ste 3W
Dobbs Ferry, NY 10522
Phone (914) 330-8445

171 Route 202
Garnerville, NY 10923
Phone (845) 947-1772

22 Saw Mill River Rd
Ste 2
Hawthorne, NY 10532
Phone (914) 593-1606

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1477790061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ASHFORD AVE STE 3W",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221824",
            "telephone_number": "914-330-8445",
            "fax_number": "914-330-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ASHFORD AVE STE 3W",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105221824",
            "telephone_number": "914-330-8445",
            "fax_number": "914-330-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NITIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-19",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "253963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03524834",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dobbs Ferry, NY

Sources for this page

Verify at the official NPI Registry.