Individual provider Active NPI

Sanjay Gupta, M.D.

  • Surgical Critical Care Physician
  • Lewiston, ME
National Provider Identifier
1801803523
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
249981 Issued in MA
Practice address
12 High St
Ste 401
Lewiston, ME 04240-7676
Phone
(207) 795-5767
Fax
(207) 795-2732
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 017630 ME
Surgical Critical Care Physician 2086S0102X 249981 MA Primary

Addresses

Primary practice location

12 High St
Ste 401
Lewiston, ME 04240-7676

Mailing address

12 High St
Ste 401
Lewiston, ME 04240-7676
Phone (207) 795-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120214000598 NH Practitioner - General Surgery 6608870225 Reassigns benefits to 1 organization
I20120417000535 MA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6608870225 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph Hospital of Nashua NHGroup PAC ID 2062455611, 271 clinicians

Practice addresses (Care Compare)

168 Kinsley St
Nashua, NH 03060-3634
Phone (603) 598-0455

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as group
Quality
88.12
Promoting interoperability
71
Improvement activities
40
Cost
77.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017630MEMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital of Nashua NH Current Accepting new patients
Coastal Medical Associates CurrentSince Nov 1, 2021 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jul 23, 2020 Accepting new patients
St Joseph Hospital of Nashua NH CurrentSince Dec 1, 2025 Accepting new patients
Lahey Clinic, Inc CurrentSince Jul 23, 2020 Accepting new patients
Sansa Med Spa LLC Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

25 Marston St
Ste 301
Lawrence, MA 01841
Phone (978) 946-8230

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

168 Kinsley St
Nashua, NH 03060
Phone (603) 578-9363

Organizations & group practices 6

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1801803523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "address_2": "STE 401",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407676",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "address_2": "STE 401",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407676",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "ME",
            "license": "017630",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MA",
            "license": "249981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.