NPIMap

Individual provider Active NPI

Elaine Catherine Gupta, NP

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1790376390
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
7979 Issued in MN
Practice address
324 E 35TH St
Minneapolis, MN 55408-4580
Phone
(612) 827-7181
NPI assigned
Jan 27, 2021
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 7979 MN Primary

Addresses

Primary practice location

324 E 35TH St
Minneapolis, MN 55408-4580

Mailing address

5309 Zenith Ave S
Minneapolis, MN 55410-2138
Phone (636) 236-7621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210308001663 MN Practitioner - Nurse Practitioner 2062828536

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southside Community Health Services IncGroup PAC ID 8921027228, shared by 2 NPIs, 2 clinicians

Practice addresses (Care Compare)

324 E 35TH St
Minneapolis, MN 55408-4580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Community Health Services, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Southside Community Health Services, Inc. CurrentSince Mar 1, 2021 Accepting new patients

Locations

324 E 35th St
Minneapolis, MN 55408
Phone (612) 827-7181

4243 4th Ave S
Minneapolis, MN 55409
Phone (612) 821-2003

Organizations & group practices 2

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1790376390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5309 ZENITH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102138",
            "telephone_number": "636-236-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 35TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084580",
            "telephone_number": "612-827-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ELAINE",
        "middle_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "7979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.