Active NPI
Mamta R. Gupta, M.D.
- Diagnostic Radiology Physician
- Cupertino, CA
National Provider Identifier
1659691889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 148757
- Practice address
- 1535 Jamestown Dr
Cupertino, CA 95014-5312 - Phone
- (952) 595-1100
- Fax
- (612) 294-4903
- NPI assigned
- Jun 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 148757 | CA | Primary |
Addresses
Primary practice location
1535 Jamestown Dr
Cupertino, CA 95014-5312
Mailing address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148757 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1659691889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11995 SINGLETREE LN STE 500",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553445349",
"telephone_number": "952-595-1301",
"fax_number": "612-294-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 JAMESTOWN DR",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950145312",
"telephone_number": "952-595-1100",
"fax_number": "612-294-4903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "MAMTA",
"middle_name": "R.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "148757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.