Active NPI
Nisha Gupta
- Plastic and Reconstructive Surgery Physician
- Culver City, CA
National Provider Identifier
1770352239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 17566
- Practice address
- 10601 Washington Blvd
Culver City, CA 90232-3385 - Phone
- (352) 206-6800
- NPI assigned
- Dec 26, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 17566 | CA | Primary |
Addresses
Primary practice location
10601 Washington Blvd
Culver City, CA 90232-3385
Mailing address
2512 Q St NW Apt 322
Washington, DC 20007-4464
Phone (352) 206-6800
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250813003980 | CA | Order and Referring Only - Plastic and Reconstructive Surgery | 4284132648 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17566 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1770352239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2512 Q ST NW APT 322",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200074464",
"telephone_number": "352-206-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10601 WASHINGTON BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902323385",
"telephone_number": "352-206-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "NISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-26",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "CA",
"license": "17566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.