Organization Active NPI

B Rai Gupta MD PA

  • Specialist
  • Lake Mary, FL
National Provider Identifier
1821339755
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
B RAI GUPTA MD PA
Doing business as
Fl Center for Plastic & Hand Surgery
Practice address
3300 W Lake Mary Blvd
Suite 220
Lake Mary, FL 32746-3570
Phone
(407) 321-7111
Fax
(407) 321-7446
NPI assigned
Mar 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Authorized official

Name
Mrs. Susan L Holland, BSN
Title
Business Account Manager
Phone
(407) 321-7111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X FL Primary

Addresses

Primary practice location

3300 W Lake Mary Blvd
Suite 220
Lake Mary, FL 32746-3570

Mailing address

3300 W Lake Mary Blvd
Suite 220
Lake Mary, FL 32746-3570
Phone (407) 321-7111

Other names 1

  • Fl Center for Plastic & Hand Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130314000478 FL Part B Supplier - Clinic/Group Practice 9830334184 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Mary, FL

National Provider Directory

National Provider Directory
Tax ID family
B Rai Gupta MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3300 W Lake Mary Blvd
Ste 220
Lake Mary, FL 32746
Phone (407) 321-4567

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1821339755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W LAKE MARY BLVD",
            "address_2": "SUITE 220",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463570",
            "telephone_number": "407-321-7111",
            "fax_number": "407-321-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W LAKE MARY BLVD",
            "address_2": "SUITE 220",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463570",
            "telephone_number": "407-321-7111",
            "fax_number": "407-321-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B RAI GUPTA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS ACCOUNT MANAGER",
        "authorized_official_telephone_number": "407-321-7111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fl Center for Plastic & Hand Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.