Individual provider Active NPI

Nandita Gupta

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1760020655
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
11024358A Issued in IN
Practice address
7165 Clearvista Way
Indianapolis, IN 46256-4621
Phone
(317) 621-5700
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11024358A IN Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

7165 Clearvista Way
Indianapolis, IN 46256-4621

Mailing address

7165 Clearvista Way
Indianapolis, IN 46256-4621

Other practice location 1

405 Central Ave
Northfield, IL 60093-3006
Phone (847) 441-5600

Other identifiers 1

IdentifierTypeStateIssuer
300114513MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250606002770 IN Order and Referring Only - PsychiatryPractitioner - Psychiatry 2668982869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11024358AINMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: ngupta650019@ecommunitydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1760020655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7165 CLEARVISTA WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 CLEARVISTA WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564621",
            "telephone_number": "317-621-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "IL",
            "postal_code": "600933006",
            "country_code": "US",
            "telephone_number": "847-441-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NANDITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11024358A",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300114513",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.