Amol K Gupta MD Corporation

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME97749 Issued in FL

Legal business name

AMOL K GUPTA MD CORPORATION

Practice address

345 Clyde Morris Blvd
Ste 390
Ormond Beach, FL 32174-3111

Phone

(386) 673-0075

Fax

(386) 673-0049

NPI assigned

Jan 4, 2008

Last updated

Mar 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amol K Gupta, M.D.NPI 1083824817

Title

Owner

Phone

(386) 673-0075

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amol K Gupta, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Ormond Beach, FL
  • NPI 1083824817
  Medicare reassignment Care Compare group NPD Authorized official
• Sheila R Gupta

  • Endocrinology, Diabetes & Metabolism Physician
  • Ormond Beach, FL
  • NPI 1487668463
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1710162094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CLYDE MORRIS BLVD",
            "address_2": "STE 390",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743111",
            "telephone_number": "386-673-0075",
            "fax_number": "386-673-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CLYDE MORRIS BLVD",
            "address_2": "STE 390",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743111",
            "telephone_number": "386-673-0075",
            "fax_number": "386-673-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMOL K GUPTA MD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "AMOL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-673-0075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME97749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.