Organization Active NPI

Abhay Gupta, M.D., Inc.

Doing business as Gupta Plastic Surgery

  • Plastic Surgery Physician
  • San Diego, CA
National Provider Identifier
1831331198
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A88550 Issued in CA
Legal business name
ABHAY GUPTA, M.D., INC.
Doing business as
Gupta Plastic Surgery
Practice address
10672 Wexford St
Suite 275
San Diego, CA 92131-3969
Phone
(858) 621-6000
Fax
(858) 621-6340
NPI assigned
Apr 1, 2009
Last updated
May 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Authorized official

Name
Abhay Gupta, M.D.NPI 1629165428
Title
President / Medical Director
Phone
(858) 621-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X A88550 CA Primary

Addresses

Primary practice location

10672 Wexford St
Suite 275
San Diego, CA 92131-3969

Mailing address

10672 Wexford St
Suite 275
San Diego, CA 92131-3969
Phone (858) 621-6000

Other identifiers 1

IdentifierTypeStateIssuer
A88550OtherCASTATE LICENSE

Other names 1

  • Gupta Plastic Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090610000347 CA Part B Supplier - Clinic/Group Practice 9931259165 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

10672 Wexford St
Ste 275
San Diego, CA 92131
Phone (858) 621-6000

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": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1831331198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10672 WEXFORD ST",
            "address_2": "SUITE 275",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313969",
            "telephone_number": "858-621-6000",
            "fax_number": "858-621-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10672 WEXFORD ST",
            "address_2": "SUITE 275",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313969",
            "telephone_number": "858-621-6000",
            "fax_number": "858-621-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABHAY GUPTA, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ABHAY",
        "authorized_official_title_or_position": "PRESIDENT / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "858-621-6000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A88550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A88550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gupta Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.