Vijay Gupta, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

01031383A Issued in IN

Practice address

8840 Calumet Ave
Suite 103
Munster, IN 46321-2545

Phone

(219) 836-7246

Fax

(219) 836-6454

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Broadwest Specialty Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Merrillville, IN
  • NPI 1770532194
  NPD Authorized official
• Serenity Surgical, LLC

  • Ambulatory Surgical Clinic/Center
  • Munster, IN
  • NPI 1073987053
  NPD (past)
• Justice Med Lab

  • Clinical Medical Laboratory
  • Justice, IL
  • NPI 1336291236
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1740289313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 CALUMET AVE",
            "address_2": "SUITE 103",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212545",
            "telephone_number": "219-836-7246",
            "fax_number": "219-836-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 CALUMET AVE",
            "address_2": "SUITE 103",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212545",
            "telephone_number": "219-836-7246",
            "fax_number": "219-836-6454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Lake Park Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Hobart",
            "state": "IN",
            "postal_code": "463426791",
            "country_code": "US",
            "telephone_number": "219-947-6695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "VIJAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01031383A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "01031383A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "050056006",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100188860A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000091129",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "01031383A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yasmeen Guerrero
• Kaylin Marie Guglielmo, OTR
• Milli Jain Gupta, M.D.
• Nisheeth Gupta, M.D.
• Shaila Bhatt Gupta, D.O.
• Devashree Dhananjay Gupte
• Harini Gurram, MD
• John Gustaitis, M.D.
• Mary Lou Guthrie, RN
• H Alan Jones D O Inc.

• Pain Medicine (Anesthesiology) Physician in Munster, IN
• Providers in Munster, IN by specialty
• Pain Medicine (Anesthesiology) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.