Aditi Gupta

Individual provider Active NPI Family Medicine Physician · Winthrop, MA

NPI 1700412640 · NPPES record last updated Aug 25, 2023

Key facts

NPI
1700412640
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
1016344 (MA)
Practice address
52 Crest Ave Ste 1
Winthrop, MA 02152-1058
Phone
(161) 784-6862
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
No

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hallmark Health Medical Associates Inc (151 clinicians)

Practice addresses (Care Compare)

425 Revere St
Revere, MA 02151-4543
Phone (781) 665-6606

52 Crest Ave
Suite 1
Winthrop, MA 02152-1058
Phone (617) 846-8622

Hospital & facility affiliations

  • Melrosewakefield Healthcare Hospital · Melrose, MA · CCN 220070

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230919003643 MA Practitioner - Family Practice 6002270337 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1016344MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Family Medicine Current
since Sep 1, 2023
Accepting new patients

Locations

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

52 Crest Ave
Ste 1
Winthrop, MA 02152
Phone (617) 846-8622

52 Crest Ave
Winthrop, MA 02152
Phone (617) 539-0197

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1016344 MA Yes

Addresses

Primary practice location

52 Crest Ave Ste 1
Winthrop, MA 02152-1058

Mailing address

14 E Olive St
Long Beach, NY 11561-3507

Other providers in Winthrop, MA

All providers in Winthrop, MA · Family Medicine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.