NPIMap

Individual provider Active NPI

Anjan Gupta, MD

  • Interventional Cardiology Physician
  • Ravenna, OH
National Provider Identifier
1780653154
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
37401-020 Issued in WI
Practice address
6847 N Chestnut St Ste 100
Ravenna, OH 44266-3929
Phone
(330) 297-6110
Fax
(330) 296-0592
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 37401 WI
Interventional Cardiology Physician 207RI0011X 37401-020 WI Primary

Addresses

Primary practice location

6847 N Chestnut St Ste 100
Ravenna, OH 44266-3929

Mailing address

PO Box 2040
Milwaukee, WI 53201-2040
Phone (414) 649-3370

Other identifiers 1

IdentifierTypeStateIssuer
32278400MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anjangupta@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150521000397 OH Practitioner - Cardiovascular Disease (Cardiology) 5890742449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

13207 Ravenna Rd
Chardon, OH 44024-7032
Phone (216) 383-0100

13207 Ravenna Rd H
Chardon, OH 44024-7032
Phone (216) 383-0100

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

  • University Hospitals Portage Medical Center Hospital, Ravenna, OH, CCN 360078
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Uh Regional Hospitals Hospital, Chardon, OH, CCN 360075
  • Crystal Clinic Orthopaedic Center Hospital, Akron, OH, CCN 360351
  • Summa Health System Hospital, Akron, OH, CCN 360020

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting40
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37401WIMDCardiovascular Disease Physician
37401-020WIMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc Cardiovascular Disease CurrentSince Sep 1, 2016 Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 1, 2016 Accepting new patients
University Primary Care Practices Past Accepting new patients
Midwest Area Physicians, LLC Cardiovascular Disease Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: agupta36867@ehrdirect.uhhospitals.org

Organizations & group practices 7

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 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1780653154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2040",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532012040",
            "telephone_number": "414-649-3370",
            "fax_number": "414-649-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST STE 100",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-6110",
            "fax_number": "330-296-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ANJAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "37401",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "37401-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32278400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anjangupta@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "6847 N Chestnut St Ste 100",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442663929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.