Manju Gupta, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA42995 Issued in NJ

Practice address

332 Lafayette Avenue
Hawthorne, NJ 07506

Phone

(973) 423-0145

Fax

(973) 423-0667

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJIGAA

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.

• Gastroenterology Associates of New Jersey, LLC

  • Gastroenterology Physician
  • Woodland Park, NJ
  • NPI 1497932271
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1790717528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 LAFAYETTE AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "07506",
            "telephone_number": "973-423-0145",
            "fax_number": "973-423-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 LAFAYETTE AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "07506",
            "telephone_number": "973-423-0145",
            "fax_number": "973-423-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "MANJU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA42995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0898503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Giglio, MD
• Surendra P Goel, M.D.
• Vijay Goel, M.D.
• Joseph Grizzanti, DO
• Laura Ann Grube
• Sharon Gurriell
• Harmony Bay Wellness & TMS Therapy, P.C.
• Harold S Bressler DMD PA
• Brianne Leigh Hartmann
• Noreen M Hartnett

• All providers in Hawthorne, NJ
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.

Verify at the official NPI Registry.