Active NPI
Suresh Gupta MD Inc
- Specialist
- Dayton, OH
National Provider Identifier
1508895640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- SURESH GUPTA MD INC
- Practice address
- 1010 Woodman Dr
Dayton, OH 45432 - Phone
- (937) 424-2215
- Fax
- (937) 252-1224
- NPI assigned
- Jul 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sapna Gupta
- Title
- Chief Legal Officer
- Phone
- (937) 620-0720
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary | ||
| Pain Clinic/Center | 261QP3300X | OH | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
1010 Woodman Dr
Dayton, OH 45432
Mailing address
1010 Woodman Dr
Dayton, OH 45432-1400
Phone (937) 424-2215
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2059481 | Medicaid | OH | |
| 7683860001 | Other | MEDICARE NSC | |
| 9276732 | Other | OH | MEDICARE |
Other names 1
- Pain Management Associates
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040127001187 | OH | Part B Supplier - Clinic/Group Practice | 3173426350 |
Receives reassigned benefits from 11 practitioners Practice locations: Greenville, OH; West Chester, OH; Troy, OH; Middletown, OH; Fairborn, OH; Dayton, OH |
| O20180723003506 | OH | DME Supplier - Physician - Interventional Pain Management | 3173426350 | Practice locations: Dayton, OH |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2077807 | Suresh Gupta MD Inc Dba Pain | Certificate of waiver | May 14, 2028 |
National Provider Directory
National Provider DirectoryLocations
1010 Woodman Dr
Ste 200
Dayton, OH 45432
Phone (937) 208-2020
1010 Woodman Dr
Ste 100
Dayton, OH 45432
Phone (937) 252-5500
7450 S Mason Montgomery Rd
Unit 201
Mason, OH 45040
Phone (513) 229-7791
30 W McCreight Ave
Springfield, OH 45504
Phone (937) 323-3585
1301 W 1st St
Springfield, OH 45504
Phone (937) 271-0066
998 S Dorset Rd
Ste 206
Troy, OH 45373
Phone (937) 332-1165
8230 Beckett Park Dr
Ste C
West Chester, OH 45069
8230 Beckett Park Dr
West Chester, OH 45069
Practitioners & affiliated clinicians
Practitioners 25
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Dayton, OH
- NPI 1811284326
OH
-
- Nurse Practitioner
- Troy, OH
- NPI 1407465636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1672012800000",
"number": "1508895640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 WOODMAN DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454321400",
"telephone_number": "937-424-2215",
"fax_number": "937-252-1224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 WOODMAN DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "45432",
"telephone_number": "937-424-2215",
"fax_number": "937-252-1224"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURESH GUPTA MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-01",
"last_updated": "2022-12-26",
"certification_date": "2022-12-26",
"status": "A",
"authorized_official_last_name": "GUPTA",
"authorized_official_first_name": "SAPNA",
"authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
"authorized_official_telephone_number": "937-620-0720"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP3300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Pain",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2059481",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NSC",
"identifier": "7683860001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "9276732",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pain Management Associates",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Pain Management Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; 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.