Sunil Gupta, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101038914 Issued in VA

Practice address

19415 Deerfield Ave
Suite 303
Leesburg, VA 20176-8472

Phone

(703) 297-4865

Fax

(703) 858-7740

NPI assigned

Dec 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CABHAA/Endpoint/CABHAA
• Direct secure messaging: sunil.gupta@pnbc.eclinicaldirectplus.com

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1659357523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE",
            "address_2": "STE 303",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768472",
            "telephone_number": "703-297-4865",
            "fax_number": "703-858-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE",
            "address_2": "SUITE 303",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768472",
            "telephone_number": "703-297-4865",
            "fax_number": "703-858-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SUNIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101038914",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VA",
            "license": "0101038914",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101038914",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659357523",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Rae Guastella, CNM,ARNP
• Madona Guirgis
• Marina Olivia Guirguis Hanna, M.D.
• Emily Tanski Gunnells, PA-C
• Charu Gupta, PA-C
• Lynn Gurley, LCSW
• Amanda Elizabeth Gushard-Edwards, LCSW
• Jennifer Gut
• Augustina Aku Gyesiwah
• Phu Ha

• Pediatrics Physician in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.