NPIMap

Individual provider Active NPI

Namita Gupta Wijesekera, M.D.

  • Pediatrics Physician
  • Woodbridge, CT
National Provider Identifier
1558631325
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
049196 Issued in CT
Practice address
8 Lunar Dr
Woodbridge, CT 06525-2352
Phone
(203) 397-5211
Fax
(203) 397-1875
NPI assigned
Jan 10, 2012
Last updated
Jan 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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 049196 CT Primary
Pediatric Adolescent Medicine Physician 2080A0000X 049196 CT

Addresses

Primary practice location

8 Lunar Dr
Woodbridge, CT 06525-2352

Mailing address

8 Lunar Dr
Woodbridge, CT 06525-2352
Phone (203) 397-5211

Other names 1

  • Dr. Namita Gupta Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
049196CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Pediatrics Past Accepting new patients
Sydney Z Spiesel PHD MD LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: namita.wijesekera.1@11240.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1558631325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LUNAR DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252352",
            "telephone_number": "203-397-5211",
            "fax_number": "203-397-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LUNAR DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252352",
            "telephone_number": "203-397-5211",
            "fax_number": "203-397-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJESEKERA",
        "first_name": "NAMITA",
        "middle_name": "GUPTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "049196",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "049196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAMITA",
            "last_name": "GUPTA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbridge, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.