NPIMap

Individual provider Active NPI

Vikram Gupta, M.D.

  • Family Medicine Physician
  • Clifton, NJ
National Provider Identifier
1750538609
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA08471700 Issued in NJ
Practice address
246 Clifton Ave Ste 4
Clifton, NJ 07011-1953
Phone
(973) 330-6765
Fax
(973) 939-8489
NPI assigned
Aug 22, 2008
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08471700 NJ Primary
General Practice Physician 208D00000X 25MA08471700 NJ

Addresses

Primary practice location

246 Clifton Ave Ste 4
Clifton, NJ 07011-1953

Mailing address

PO Box 3399
Wayne, NJ 07474-3399
Phone (973) 330-6765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000595 NJ Practitioner - Family Practice 0042371809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gmed Healthcare PCGroup PAC ID 8022292564, 6 clinicians

Practice addresses (Care Compare)

246 Clifton Ave
Suite 4
Clifton, NJ 07011-1953
Phone (973) 928-2715

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08471700NJMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gmed Healthcare PC Family Medicine CurrentSince Nov 22, 2010 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients
Prime Healthcare Services - St. Mary's Passaic LLC Past Accepting new patients
West Paterson Family Medical Center,PA PastSince Aug 1, 2013 Accepting new patients

Locations

246 Clifton Ave
Ste 4
Clifton, NJ 07011
Phone (973) 330-6765

124 Gregory Ave
Ste 102
Passaic, NJ 07055
Phone (973) 777-1132

466 Chamberlain Ave
#2
Paterson, NJ 07522

466 Chamberlain Ave
Ste 2
Paterson, NJ 07522
Phone (973) 928-2715

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1750538609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3399",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074743399",
            "telephone_number": "973-330-6765",
            "fax_number": "973-939-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 CLIFTON AVE STE 4",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111953",
            "telephone_number": "973-330-6765",
            "fax_number": "973-939-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "VIKRAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08471700",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA08471700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.