NPIMap

Individual provider Active NPI

Renu Gupta, M.D.

  • Specialist
  • Medford, OR
National Provider Identifier
1609062439
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD154260 Issued in OR
Practice address
760 Golf View Drive
Suite #200
Medford, OR 97504-9685
Phone
(541) 618-4400
Fax
(541) 618-4406
NPI assigned
Sep 14, 2007
Last updated
Dec 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD154260 OR Primary

Addresses

Primary practice location

760 Golf View Drive
Suite #200
Medford, OR 97504-9685

Mailing address

760 Golf View Drive
Suite #200
Medford, OR 97504-9685
Phone (541) 618-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110812000206 OR Practitioner - NephrologyPractitioner - Internal Medicine 8527123868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Care Consultants PCGroup PAC ID 9830179134, 13 clinicians

Practice addresses (Care Compare)

760 Golf View Dr
Unit 200
Medford, OR 97504-9685
Phone (541) 618-4400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Apr 27, 2021 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Apr 27, 2021 Accepting new patients
Renal Care Consultants PC Specialist CurrentSince Jul 5, 2011 Accepting new patients

Locations

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

760 Golf View Dr
Unit 200
Medford, OR 97504
Phone (541) 618-4400

Interoperability endpoints

  • Direct secure messaging: renugupta@rccpc.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1609062439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 GOLF VIEW DRIVE",
            "address_2": "SUITE #200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049685",
            "telephone_number": "541-618-4400",
            "fax_number": "541-618-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 GOLF VIEW DRIVE",
            "address_2": "SUITE #200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049685",
            "telephone_number": "541-618-4400",
            "fax_number": "541-618-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RENU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD154260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.