Individual provider Active NPI

Avani Patel Gupta

  • Diagnostic Radiology Physician
  • Redwood City, CA
National Provider Identifier
1760657415
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A128355 Issued in CA
Practice address
170 Alameda de Las Pulgas
Redwood City, CA 94062-2751
Phone
(844) 357-3127
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A128355 CA Primary

Addresses

Primary practice location

170 Alameda de Las Pulgas
Redwood City, CA 94062-2751

Mailing address

170 Alameda de Las Pulgas
Redwood City, CA 94062-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141015001101 CA Practitioner - Diagnostic Radiology 4284855347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Image Guided Therapeutics IncGroup PAC ID 6608874896, 16 clinicians

Practice addresses (Care Compare)

170 Alameda de Las Pulgas
Redwood City, CA 94062-2751
Phone (650) 369-5811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128355CAMDClinical Social Worker
A128355CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Image Guided Therapeutics, Inc. Diagnostic Radiology CurrentSince Aug 1, 2019 Accepting new patients

Locations

1801 W Olympic Blvd
Pasadena, CA 91199

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

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 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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1760657415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 ALAMEDA DE LAS PULGAS",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 ALAMEDA DE LAS PULGAS",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622751",
            "telephone_number": "844-357-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AVANI",
        "middle_name": "PATEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A128355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.