Individual provider Active NPI

Charu Gupta, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Vernon Hills, IL
National Provider Identifier
1689834418
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
036142074 Issued in IL
Practice address
225 N Milwaukee Ave
Vernon Hills, IL 60061
Phone
(847) 663-8410
Fax
(847) 570-1865
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036142074 IL
Cardiovascular Disease Physician 207RC0000X 036142074 IL
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 036142074 IL Primary

Addresses

Primary practice location

225 N Milwaukee Ave
Vernon Hills, IL 60061

Mailing address

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone (847) 663-8410

Other practice location 1

69 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3033
Phone (404) 616-7028

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgupta262975@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 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
I20150814014489 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 2365757648 Reassigns benefits to 2 organizations
I20170112002559 IL Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2365757648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Texas Southwestern Medical School at Dallas, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

225 N Milwaukee Ave
Vernon Hills, IL 60061-4304
Phone (847) 941-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Feb 1, 2017 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jan 1, 2016 Accepting new patients
County of Santa Clara Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
University of California SFGH Medical Group CurrentSince Jun 1, 2015 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 1, 2017 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
University of California SFGH Medical Group Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients

Locations

1001 Potrero Ave
Rm 5H22
San Francisco, CA 94110
Phone (628) 206-4774

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

9532 Eagle Way
Chicago, IL 60678

3737 W Lawrence Ave
Chicago, IL 60625
Phone (773) 366-7777

1000 Central St
Evanston, IL 60201
Phone (847) 570-1000

2650 Ridge Ave
Ste 1420
Evanston, IL 60201
Phone (847) 570-2860

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1000 Central St
Ste 730
Evanston, IL 60201
Phone (847) 663-8410

2150 Pfingsten Rd
Ste 1200
Glenview, IL 60026
Phone (847) 657-1819

225 N Milwaukee Ave
Vernon Hills, IL 60061
Phone (847) 941-7600

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1689834418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600614304",
            "telephone_number": "847-663-8410",
            "fax_number": "847-570-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "60061",
            "telephone_number": "847-663-8410",
            "fax_number": "847-570-1865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "69 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033033",
            "country_code": "US",
            "telephone_number": "404-616-7028",
            "fax_number": "404-525-2957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "CHARU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036142074",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036142074",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "IL",
            "license": "036142074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgupta262975@direct.northshore.org",
            "affiliation": "N",
            "address_1": "225 N Milwaukee Ave",
            "city": "Vernon Hills",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.