Individual provider Active NPI

Amit Gupta, MBBS; MD

  • Vascular & Interventional Radiology Physician
  • Columbus, OH
National Provider Identifier
1740599331
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
35.122381 Issued in OH
Practice address
395 W 12TH Ave RM 460
Columbus, OH 43210-1267
Phone
(614) 293-8315
Fax
(614) 293-6935
NPI assigned
Sep 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 276720 NY
Vascular & Interventional Radiology Physician 2085R0204X 35.122381 OH Primary

Addresses

Primary practice location

395 W 12TH Ave RM 460
Columbus, OH 43210-1267

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8315

Other practice location 1

HSC Level 4 RM 120
100 Nichols Road
Stony Brook, NY 11794-8460
Phone (631) 444-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20231204000392 OH Practitioner - Interventional Radiology 8022230499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians

Practice addresses (Care Compare)

395 W 12TH Ave
RM 460
Columbus, OH 43210-1267
Phone (614) 293-8315

Hospital & facility affiliations

  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.122381OHMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Oct 1, 2023 Accepting new patients

Locations

395 W 12th Ave
Rm 460
Columbus, OH 43210
Phone (614) 293-8299

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

Interoperability endpoints

  • Direct secure messaging: amit.gupta@direct.stonybrookmedicine.edu

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 4

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": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1740599331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8315",
            "fax_number": "614-293-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE RM 460",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8315",
            "fax_number": "614-293-6935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "HSC Level 4 RM 120",
            "address_2": "100 Nichols Road",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948460",
            "country_code": "US",
            "telephone_number": "631-444-5400",
            "fax_number": "631-444-7538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AMIT",
        "name_prefix": "Dr.",
        "credential": "MBBS; MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "276720",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35.122381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.