Individual provider Active NPI

Monica Gupta, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Shelby, OH
National Provider Identifier
1497436646
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0034475 Issued in OH
Practice address
24 E Whitney Ave
Shelby, OH 44875-1282
Phone
(419) 564-4667
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0034475 OH Primary

Addresses

Primary practice location

24 E Whitney Ave
Shelby, OH 44875-1282

Mailing address

5746 Glendavon PL
Dublin, OH 43016-6158
Phone (734) 678-4607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011003280 OH Practitioner - Nurse Practitioner 2365897386 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Services and TMS Center LLC Psychiatric/Mental Health CurrentSince Sep 17, 2023 Accepting new patients
Ohio Medical Associates Inc. PastSince Jan 1, 2002 Accepting new patients

Locations

5551 Hilliard Rome Office Park
Hilliard, OH 43026
Phone (614) 850-0500

109 N Broad St
Ste 301
Lancaster, OH 43130
Phone (740) 243-0247

Organizations & group practices 3

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1497436646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5746 GLENDAVON PL",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166158",
            "telephone_number": "734-678-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E WHITNEY AVE",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751282",
            "telephone_number": "419-564-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MONICA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0034475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

Verify at the official NPI Registry.