Individual provider Active NPI

Gaorav Pankaj Gupta, M.D., PH.D.

  • Radiation Oncology Physician
  • Chapel Hill, NC
National Provider Identifier
1740416478
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2015-00215 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(984) 974-1275
NPI assigned
Jun 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 253475 NY
Radiation Oncology Physician 2085R0001X 2015-00215 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

101 Manning Dr
Chapel Hill, NC 27514-4220

Other practice location 1

1275 York Ave
New York, NY 10065-6007
Phone (646) 888-3567

Other practice location 2

4420 Lake Boone Trl Ste 102
Raleigh, NC 27607-7505
Phone (919) 784-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150520002645 NC Practitioner - Radiation Oncology 9537303334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
JS Weill Medical College, Cornell University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-00215NCMDRadiation Oncology Physician
253475NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Hospital Inc Current Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Apr 1, 2015 Accepting new patients
Smithfield Radiation Oncology, LLC Radiation Oncology CurrentSince Jun 23, 2020 Accepting new patients
Johnston Radiation Oncology LLC Radiation Oncology CurrentSince Jun 23, 2020 Accepting new patients
Rex Hospital Inc Past Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

2076 Veterans Pkwy
Ste 120
Clayton, NC 27520
Phone (919) 585-8550

460 Waterstone Dr
Hillsborough, NC 27278
Phone (984) 215-2444

117 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 334-3900

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

11200 Governor Manly Way
Ste 102
Raleigh, NC 27614
Phone (919) 570-7550

4420 Lake Boone Trl
Ste 102
Raleigh, NC 27607
Phone (919) 784-1473

514 N Brightleaf Blvd
Ste 1200
Smithfield, NC 27577
Phone (919) 209-3555

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1740416478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100656007",
            "country_code": "US",
            "telephone_number": "646-888-3567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4420 Lake Boone Trl Ste 102",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "919-784-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "GAORAV",
        "middle_name": "PANKAJ",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "253475",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "2015-00215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.