Individual provider Active NPI

Andrew Sham Gupta, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Hollywood, FL
National Provider Identifier
1639430556
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
ME141614 Issued in FL
Practice address
1150 N 35TH Ave Ste 345
Hollywood, FL 33021
Phone
(954) 265-6300
Fax
(954) 961-3600
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X ME141614 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave Ste 345
Hollywood, FL 33021

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other practice location 1

3377 South State Rd 7
Suite 100
Wellington, FL 33449
Phone (561) 341-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agupta219673@MHSDIRECT.NET Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613002038 MI Practitioner - Orthopedic Surgery 6800198045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

3901 Beaubien 1St Floor
Detroit, MI 48201-2119
Phone (313) 745-5227

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Jun 1, 2024 Accepting new patients

Locations

45250 Cherry Hill Rd
Canton, MI 48187
Phone (734) 397-6270

42700 Garfield Rd
Ste 240
Clinton Township, MI 48038
Phone (313) 745-5227

42700 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 532-3380

4201 Saint Antoine St
#6D
Detroit, MI 48201
Phone (313) 966-8013

3901 Beaubien St
Fl 1
Detroit, MI 48201
Phone (313) 745-2443

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

33703 Van Dyke Ave
Sterling Heights, MI 48312
Phone (586) 558-2860

350 W Big Beaver Rd
Troy, MI 48084
Phone (248) 524-7180

Interoperability endpoints

  • Direct secure messaging: agupta219673@mhsdirect.net
  • Direct secure messaging: andrew.gupta.1@9704.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1639430556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 345",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-6300",
            "fax_number": "954-961-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 South State Rd 7",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "33449",
            "country_code": "US",
            "telephone_number": "561-341-7000",
            "fax_number": "561-784-7098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ANDREW",
        "middle_name": "SHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "FL",
            "license": "ME141614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agupta219673@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N 35th Ave Ste 345",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.