Prodosh R. Sen-Gupta, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

27354 Issued in IA

Practice address

2710 Saint Francis Dr
Suite 410
Waterloo, IA 50702-5619

Phone

(319) 272-5000

Fax

(319) 272-5264

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1538106943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "address_2": "SUITE 410",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEN-GUPTA",
        "first_name": "PRODOSH",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "27354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3113993",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tysha Scott
• Christina Scruggs
• Gwynavia Monique Scullark
• Seeds for Growth
• Michael Sell, RPH
• Serene Living Homes, LLC
• Rafael Serrano Riera, M.D.
• Sarah Jessica Seuntjens, CNM
• Deanna Shafer, LISW
• Sangeeta Shah, MD

• Anesthesiology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Anesthesiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.