Active NPI
Anju Gupta-Modak, MD
- Neonatal-Perinatal Medicine Physician
- Brooklyn, NY
National Provider Identifier
1891780276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 225285
- Practice address
- 4802 10TH Ave
Brooklyn, NY 11219-2844 - Phone
- (718) 283-8853
- Fax
- (718) 635-7235
- NPI assigned
- Sep 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 225285 | NY | Primary |
Addresses
Primary practice location
4802 10TH Ave
Brooklyn, NY 11219-2844
Mailing address
977 48TH St
Brooklyn, NY 11219-2919
Phone (718) 283-8015
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26N9651 | Other | NY | NEIGHBORHOOD HEALTH |
| 2603107 | Other | NY | GHI |
| 001131-A15 | Other | NY | HEALTH FIRST |
| 4C4442 | Other | NY | HEALTH NET |
| GA5285 | Other | NY | ATLANTIS HEALTH PLAN |
| P2068431 | Other | NY | OXFORD HEALTH PLANS |
| 001131 | Other | NY | HIP |
| 02109608 | Medicaid | NY | |
| 0B7762 | Other | NY | EMPIRE BCBS |
| 1000030331 | Other | NY | AFFINITY HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001131 | NY | MD | Acupuncturist |
| 225285 | NY | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maimonides Medical Center | Current | Accepting new patients | |
| Maimonides Faculty Practice Plan | Current | Accepting new patients | |
| MMC Pediatrics Faculty Practice | Current | Accepting new patients | |
| LMC Physician Services, PC | Past | Accepting new patients |
Locations
4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018
4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724
977 48th St
Brooklyn, NY 11219
Phone (718) 283-8894
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- anjuguptamodak@mai.allscriptsdirect.net
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1053344846
-
- Pediatrics Physician
- Brooklyn, NY
- NPI 1285648154
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1093777492
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1346256104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1891780276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "977 48TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192919",
"telephone_number": "718-283-8015",
"fax_number": "718-635-7235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 10TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192844",
"telephone_number": "718-283-8853",
"fax_number": "718-635-7235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA-MODAK",
"first_name": "ANJU",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-13",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NY",
"license": "225285",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "26N9651",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "2603107",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH FIRST",
"identifier": "001131-A15",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "4C4442",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATLANTIS HEALTH PLAN",
"identifier": "GA5285",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "P2068431",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP",
"identifier": "001131",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02109608",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS",
"identifier": "0B7762",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AFFINITY HEALTH PLAN",
"identifier": "1000030331",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.