Individual provider Active NPI

Mudit Gupta, MD PHD

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1518316397
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD467159 Issued in PA
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(215) 590-4040
NPI assigned
Jun 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD467159 PA Primary
Pediatric Cardiology Physician 2080P0202X MD467159 PA

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

2929 Arch St FL 12
Philadelphia, PA 19104-2857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240212002548 PA Practitioner - Cardiovascular Disease (Cardiology) 3375986821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Health Care Associates IncGroup PAC ID 1355253527, 211 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD467159PAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Cardiology CurrentSince Jan 1, 2024 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Jan 1, 2024 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

2929 Arch St
Fl 12
Philadelphia, PA 19104

3401 Civic Center Blvd
#M975
Philadelphia, PA 19104

3401 Civic Center Blvd
Rm 55
Philadelphia, PA 19104
Phone (215) 510-1220

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": "1465689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1518316397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 ARCH ST FL 12",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MUDIT",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-12",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD467159",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD467159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.