Organization Active NPI

Alicja Gupta MDPC

  • Internal Medicine Physician
  • Quincy, MA
National Provider Identifier
1790803294
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALICJA GUPTA MDPC
Practice address
21 Mayor Thomas J McGrath Hwy
Suite 202
Quincy, MA 02169-5351
Phone
(617) 773-2709
Fax
(617) 479-4642
NPI assigned
Mar 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alicja U Gupta, MDNPI 1295731032
Title
President
Phone
(617) 773-2709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

21 Mayor Thomas J McGrath Hwy
Suite 202
Quincy, MA 02169-5351

Mailing address

21 Mayor Thomas J McGrath Hwy
Suite 202
Quincy, MA 02169-5351
Phone (617) 773-2709

Other identifiers 3

IdentifierTypeStateIssuer
2027879MedicaidMA
1295731032OtherMAINDIVIDUAL NPI
9715291MedicaidMA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790803294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MAYOR THOMAS J MCGRATH HWY",
            "address_2": "SUITE 202",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695351",
            "telephone_number": "617-773-2709",
            "fax_number": "617-479-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MAYOR THOMAS J MCGRATH HWY",
            "address_2": "SUITE 202",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695351",
            "telephone_number": "617-773-2709",
            "fax_number": "617-479-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICJA GUPTA MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ALICJA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-773-2709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027879",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1295731032",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9715291",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.