NPIMap

Organization Active NPI

Sunil Gupta MD LLC

Doing business as Retina Specialty Institute

  • Ophthalmology Physician
  • Daphne, AL
National Provider Identifier
1871160085
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SUNIL GUPTA MD LLC
Doing business as
Retina Specialty Institute
Practice address
30169 Woodrow LN Ste B
Daphne, AL 36527-7641
Phone
(850) 476-6759
Fax
(850) 484-5222
NPI assigned
Jun 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Sunil Gupta, MD
Title
Managing Partner
Phone
(850) 476-6759

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0107X

Addresses

Primary practice location

30169 Woodrow LN Ste B
Daphne, AL 36527-7641

Mailing address

5150 N Davis Hwy
Pensacola, FL 32503-2030
Phone (850) 476-6759

Other names 1

  • Retina Specialty Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Retina Specialty Institute8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

5150 N Davis Hwy
Pensacola, FL 32503

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1871160085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032030",
            "telephone_number": "850-476-6759",
            "fax_number": "850-484-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30169 WOODROW LN STE B",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365277641",
            "telephone_number": "850-476-6759",
            "fax_number": "850-484-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNIL GUPTA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "850-476-6759",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Retina Specialty Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.