Individual provider Active NPI

Deepali Gupta, M.D.

  • Interventional Pain Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1689802464
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
2MA09728700 Issued in NJ
Practice address
800 Poly PL
Brooklyn, NY 11209-7104
Phone
(718) 836-6600
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Pain Medicine Physician 208VP0014X 2MA09728700 NJ Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 2MA09728700 NJ
Anesthesiology Physician 207L00000X 2MA09728700 NJ

Addresses

Primary practice location

800 Poly PL
Brooklyn, NY 11209-7104

Mailing address

125 Court St
Apt 6HN
Brooklyn, NY 11201-5663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150821013897 NJ Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 0143535955 Reassigns benefits to 1 organization
I20200526002142 NY Practitioner - AnesthesiologyPractitioner - Pain Management 0143535955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
New York University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York Pain Care PCGroup PAC ID 5597950154, 4 clinicians
New Jersey Pain Care Center PCGroup PAC ID 4486703121, 4 clinicians

Practice addresses (Care Compare)

41 5TH Ave
Suite 1A1B
New York, NY 10003-4319
Phone (212) 604-1300

44 State RT
23 Suite 15B
Riverdale, NJ 07457-1603
Phone (973) 400-1716

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2MA09728700NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Pain Care Center PC CurrentSince Mar 3, 2022 Accepting new patients
New York Pain Care PC Multi-Specialty CurrentSince Mar 8, 2022 Accepting new patients
Riverside Spine and Pain Medicine, PC Multi-Specialty CurrentSince Feb 1, 2020 Accepting new patients
New York Pain Care PC CurrentSince Mar 8, 2022 Accepting new patients
New Jersey Pain Care Center PC Multi-Specialty CurrentSince Mar 3, 2022 Accepting new patients

Locations

44 State Rt 23
Ste 15B
Riverdale, NJ 07457
Phone (973) 400-1716

41 5th Ave
Apt 1C
New York, NY 10003
Phone (212) 473-7777

65 Broadway
Ste 1605
New York, NY 10006
Phone (212) 242-8160

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1689802464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COURT ST",
            "address_2": "APT 6HN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "DEEPALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "2MA09728700",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "2MA09728700",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "2MA09728700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.