NPIMap

Individual provider Active NPI

Pankaj Chand Gupta, M.D.

  • Ophthalmology Physician
  • North Canton, OH
National Provider Identifier
1609929371
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35-099606 Issued in OH
Practice address
5890 Mayfair Rd
North Canton, OH 44720-1547
Phone
(330) 305-2200
Fax
(330) 305-2210
NPI assigned
Jan 18, 2007
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 227967 MA
Ophthalmology Physician 207W00000X 35-099606 OH Primary

Addresses

Primary practice location

5890 Mayfair Rd
North Canton, OH 44720-1547

Mailing address

5890 Mayfair Rd
North Canton, OH 44720-1547
Phone (330) 305-2200

Other identifiers 2

IdentifierTypeStateIssuer
0069769MedicaidOH
P01168884OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120906000276 OH Practitioner - Ophthalmology 4789786211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ohio State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Eye Care, Inc.Group PAC ID 6103850581, 11 clinicians

Practice addresses (Care Compare)

15840 Medical Dr S
Suite a
Findlay, OH 45840-7833
Phone (419) 422-6190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.75 of 100Reported as group
Quality
97.58
Improvement activities
40
Cost
52.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
227967MAMDOphthalmology Physician
35-099606OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Eye Care Inc Ophthalmology CurrentSince Sep 1, 2022 Accepting new patients
Roholt Vision Instititute Inc Ophthalmology Current Accepting new patients
Roholt Vision Institute Inc Ophthalmology CurrentSince Nov 1, 2020 Accepting new patients
Roholt Vision Institute Inc Ophthalmology CurrentSince Nov 1, 2020 Accepting new patients
Spectrum Eye Care, Inc. Ophthalmology CurrentSince Sep 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
South Suburban Ear, Nose & Throat Assoc Inc Past Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Ophthalmology Past Accepting new patients

Locations

1207 W State St
Alliance, OH 44601
Phone (330) 451-1310

25 Manor Hill Dr
Canfield, OH 44406
Phone (330) 702-8755

15840 Medical Dr S
Ste A
Findlay, OH 45840
Phone (419) 422-6190

5890 Mayfair Rd
Green, OH 44720
Phone (330) 305-2200

2300 Baton Rouge
Lima, OH 45805
Phone (419) 422-6190

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-spectrum

Organizations & group practices 8

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 3

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1609929371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5890 MAYFAIR RD",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447201547",
            "telephone_number": "330-305-2200",
            "fax_number": "330-305-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 MAYFAIR RD",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447201547",
            "telephone_number": "330-305-2200",
            "fax_number": "330-305-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PANKAJ",
        "middle_name": "CHAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "227967",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35-099606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069769",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01168884",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.