Active NPI
Amar Gupta, M.D.
- Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
- License
- A167029
- Practice address
- 6850 Brockton Ave Ste 108
Riverside, CA 92506-3814 - Phone
- (951) 313-6843
- Fax
- (951) 800-1850
- NPI assigned
- Apr 8, 2013
- Last updated
- Aug 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 2082S0099X | A167029 | CA | Primary |
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | A167029 | CA |
Addresses
Primary practice location
6850 Brockton Ave Ste 108
Riverside, CA 92506-3814
Mailing address
6850 Brockton Ave Ste 108
Riverside, CA 92506-3814
Phone (951) 313-6843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Case Western University School of Dental Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6850 Brockton Ave
Suite 108
Riverside, CA 92506-3814
Phone (951) 313-6843
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A167029 | CA | MD | Otolaryngology/Facial Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Face Institute Apc | Plastic Surgery Within the Head and Neck | Current | Accepting new patients |
| Doctors Hospital of Riverside LLC | Past | Accepting new patients | |
| Riverside Healthcare System, L.P. | Past | Accepting new patients | |
| Caritas St. Elizabeth's Medical Center | Past | Accepting new patients |
Locations
3722 Tibbetts St
Riverside, CA 92506
Phone (951) 697-1150
6850 Brockton Ave
Ste 108
Riverside, CA 92506
Phone (951) 313-6843
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- agupta676338@nychhc.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
- Riverside, CA
- NPI 1306438858
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dba Parkview Community Hospital Medical Center
- General Acute Care Hospital
- Riverside, CA
- NPI 1124596382
-
dba Riverside Community Hospital
- Rehabilitation Hospital Unit
- Riverside, CA
- NPI 1053358010
-
- Specialist
- Brighton, MA
- NPI 1770574527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1912340159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6850 BROCKTON AVE STE 108",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063814",
"telephone_number": "951-313-6843",
"fax_number": "951-800-1850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6850 BROCKTON AVE STE 108",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063814",
"telephone_number": "951-313-6843",
"fax_number": "951-800-1850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "AMAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-08",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "2082S0099X",
"taxonomy_group": "",
"desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
"state": "CA",
"license": "A167029",
"primary": true
},
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "CA",
"license": "A167029",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.