Individual provider Active NPI

Rohit Gupta, MD, PHD

  • Pediatric Gastroenterology Physician
  • Tacoma, WA
National Provider Identifier
1821225863
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD60213708 Issued in WA
Practice address
311 S L St
Tacoma, WA 98405-3720
Phone
(253) 792-6630
NPI assigned
Jun 17, 2009
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X MD60213708 WA Primary

Addresses

Primary practice location

311 S L St
Tacoma, WA 98405-3720

Mailing address

311 S L St
Tacoma, WA 98405-3720
Phone (253) 792-6630

Other identifiers 1

IdentifierTypeStateIssuer
00003MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140929002619 WA Practitioner - Pediatric MedicinePractitioner - Gastroenterology 9537291802 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Sep 22, 2014 Accepting new patients
Multicare Health System CurrentSince Sep 22, 2014 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

17700 SE 272nd St
Ste 460
Covington, WA 98042
Phone (253) 403-0077

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

17700 SE 272nd St
#460
Kent, WA 98042

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1821225863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S L ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053720",
            "telephone_number": "253-792-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S L ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053720",
            "telephone_number": "253-792-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ROHIT",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "WA",
            "license": "MD60213708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00003",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.