Sanjeev Gupta, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

210511 Issued in NY

Practice address

31 Hospital Dr
Massena, NY 13662

Phone

(315) 769-1099

Fax

(315) 769-1077

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sgupta1@hiemail.healtheconnections.org
• FHIR API: https://fhir4.healow.com/fhir/r4/HEDDBA/Endpoint/HEDDBA

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.

• Sanjeev and Mukta Gupta

  • Multi-Specialty Clinic/Center
  • Massena, NY
  • NPI 1245253830
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1558360693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HOSPITAL DR",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "13662",
            "telephone_number": "315-769-1099",
            "fax_number": "315-769-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HOSPITAL DR",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "13662",
            "telephone_number": "315-769-1099",
            "fax_number": "315-769-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SANJEEV",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "210511",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "210511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01647974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy E Green, ARNP
• Jeffrey Greenberg, M.D.
• Brenda Irene Greene, PH.D.
• Jennifer Greene
• Mukta Gupta, MD
• Elizabeth Page Hall, FNP-BC
• Snow Verdean Harper-Moulton, RN IBCLC
• Sheila Marie Hawes, OPTICIAN/CL PRACTITI
• Matthew S Hayes, PT
• Sarah Ann Henderson

• Pediatrics Physician in Massena, NY
• Providers in Massena, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.