Individual provider Active NPI

Isha Duggal Gupta, M.D.

  • Neurology Physician
  • Union, NJ
National Provider Identifier
1740577857
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA09899900 Issued in NJ
Practice address
1057 Commerce Ave
Union, NJ 07083-5025
Phone
(908) 688-2377
NPI assigned
Jul 10, 2011
Last updated
Oct 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA09899900 NJ Primary
Neurology Physician 2084N0400X 284850-1 NY

Addresses

Primary practice location

1057 Commerce Ave
Union, NJ 07083-5025

Mailing address

1057 Commerce Ave
Apt 2B
Union, NJ 07083-5025
Phone (301) 802-1069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20161024001758 NJ Practitioner - Neurology 7214215482 Reassigns benefits to 1 organization
I20181109000724 NY Practitioner - Neurology 7214215482 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284850-1NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2018 Accepting new patients
Igea Brain & Spine,PA CurrentSince Sep 19, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2018 Accepting new patients

Locations

1057 Commerce Ave
Apt 2B
Union, NJ 07083

1057 Commerce Ave
Union, NJ 07083
Phone (866) 467-1770

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGJJCD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1740577857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 COMMERCE AVE",
            "address_2": "APT 2B",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835025",
            "telephone_number": "301-802-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 COMMERCE AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835025",
            "telephone_number": "908-688-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ISHA",
        "middle_name": "DUGGAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-10",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA09899900",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "284850-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.