Individual provider Active NPI

Vivek Gupta

  • Anesthesiology Physician
  • Prince Frederick, MD
National Provider Identifier
1831117290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0062690 Issued in MD
Practice address
100 Hospital Road
Prince Frederick, MD 20678
Phone
(410) 535-8295
Fax
(410) 414-4788
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0062690 MD Primary

Addresses

Primary practice location

100 Hospital Road
Prince Frederick, MD 20678

Mailing address

PO Box 630898
Baltimore, MD 21263-0898
Phone (800) 426-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, PA2 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
I20180403002326 AZ Practitioner - Anesthesiology 0345271953 Reassigns benefits to 1 organization
I20231019003889 PA Practitioner - Anesthesiology 0345271953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd Patient Tower
Suite 3
Philadelphia, PA 19141-3092
Phone (215) 456-6850

Hospital & facility affiliations

  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142
  • Jefferson Einstein Montgomery Hospital Hospital, East Norriton, PA, CCN 390329

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062690MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Current Accepting new patients
Banner-University Medical Group Anesthesiology Current Accepting new patients
Banner-University Medical Group CurrentSince Jun 12, 2023 Accepting new patients
Einstein Practice Plan Inc CurrentSince Sep 3, 2023 Accepting new patients
Banner-University Medical Group CurrentSince Jun 12, 2023 Accepting new patients
Einstein Practice Plan Inc Anesthesiology CurrentSince Sep 3, 2023 Accepting new patients
Chesapeake Anesthesia Associates PA Anesthesiology Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

1501 N Campbell Ave
Tucson, AZ 85724
Phone (520) 626-7747

3601 S 6th Ave
Tucson, AZ 85723

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831117290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630898",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212630898",
            "telephone_number": "800-426-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL ROAD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-8295",
            "fax_number": "410-414-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "VIVEK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0062690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.