NPIMap

Individual provider Active NPI

Shelly Gupta, MD

  • Hematology & Oncology Physician
  • Dublin, CA
National Provider Identifier
1831558329
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A151829 Issued in CA
Practice address
6380 Clark Ave
Dublin, CA 94568-3036
Phone
(925) 875-1677
Fax
(925) 875-0826
NPI assigned
Feb 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X A151829 CA Primary

Addresses

Primary practice location

6380 Clark Ave
Dublin, CA 94568-3036

Mailing address

2345 Country Hills Dr
Antioch, CA 94509-7319
Phone (925) 418-0282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716001834 CA Practitioner - Hematology/Oncology 0244632974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Epic CareGroup PAC ID 5890053094, 54 clinicians

Practice addresses (Care Compare)

6380 Clark Ave
Dublin, CA 94568-3036
Phone (925) 875-1677

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151829CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Care CurrentSince Sep 20, 2021 Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
Hayward Sisters Hospital Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients

Locations

4721 Dallas Ranch Rd
Antioch, CA 94531
Phone (925) 676-2600

2345 Country Hills Dr
Antioch, CA 94509
Phone (925) 418-0278

20400 Lake Chabot Rd
Ste 102
Castro Valley, CA 94546
Phone (510) 247-9227

1320 El Capitan Dr
Ste 300
Danville, CA 94526
Phone (510) 886-3138

6380 Clark Ave
Dublin, CA 94568
Phone (925) 277-1900

1480 64th St
Ste 100
Emeryville, CA 94608
Phone (415) 565-6684

27204 Calaroga Ave
Hayward, CA 94545
Phone (510) 732-6930

388 9th St
Ste 218B
Oakland, CA 94607
Phone (510) 271-0133

1660 San Pablo Ave
Ste A
Pinole, CA 94564
Phone (510) 223-1430

400 Taylor Blvd
Ste 201
Pleasant Hill, CA 94523
Phone (510) 783-6865

13851 E 14th St
Ste 308
San Leandro, CA 94578
Phone (510) 351-1193

Interoperability endpoints

  • Direct secure messaging: sgupta586978@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1831558329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 COUNTRY HILLS DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097319",
            "telephone_number": "925-418-0282",
            "fax_number": "925-978-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6380 CLARK AVE",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683036",
            "telephone_number": "925-875-1677",
            "fax_number": "925-875-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SHELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A151829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

Verify at the official NPI Registry.