Individual provider Active NPI

Anu Gupta, M.D.

  • Specialist
  • Gaithersburg, MD
National Provider Identifier
1790780963
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101053278 Issued in VA
Practice address
808 W Diamond Ave
Gaithersburg, MD 20878-1413
Phone
(240) 364-0900
Fax
(240) 364-0838
NPI assigned
Jun 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101053278 VA Primary

Addresses

Primary practice location

808 W Diamond Ave
Gaithersburg, MD 20878-1413

Mailing address

808 W Diamond Ave
Gaithersburg, MD 20878-1413
Phone (240) 364-0900

Other identifiers 1

IdentifierTypeStateIssuer
010068029MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040915000638 DC Practitioner - Radiation Oncology 7416924766 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101053278VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Oncology Hematology P.a. CurrentSince Sep 16, 2024 Accepting new patients
Maryland Oncology Hematology P.a. CurrentSince Sep 16, 2024 Accepting new patients
Maryland Oncology Hematology, P.a. Current Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Virginia Cancer Specialists, P.C. Past Accepting new patients

Locations

11720 Beltsville Dr
Ste 300
Beltsville, MD 20705

7350 Van Dusen Rd
Ste 370
Laurel, MD 20707
Phone (301) 982-9800

9905 Medical Center Dr
Ste 100
Rockville, MD 20850
Phone (240) 826-6297

11886 Healing Way
Ste 101
Silver Spring, MD 20904
Phone (240) 471-3800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1790780963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W DIAMOND AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781413",
            "telephone_number": "240-364-0900",
            "fax_number": "240-364-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W DIAMOND AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781413",
            "telephone_number": "240-364-0900",
            "fax_number": "240-364-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ANU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101053278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010068029",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.