NPIMap

Individual provider Active NPI

Ravi P Gupta, M.D.

  • Internal Medicine Physician
  • Leesburg, FL
National Provider Identifier
1922077338
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME71724 Issued in FL
Practice address
401 North Blvd W
Leesburg, FL 34748-5044
Phone
(352) 728-4242
Fax
(352) 728-4868
NPI assigned
Mar 16, 2006
Last updated
May 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME71724 FL Primary

Addresses

Primary practice location

401 North Blvd W
Leesburg, FL 34748-5044

Mailing address

401 North Blvd W
Leesburg, FL 34748-5044
Phone (352) 728-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100721000917 FL Practitioner - Internal Medicine 9133211766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Florida Primary Care PAGroup PAC ID 7416049044, 6 clinicians

Practice addresses (Care Compare)

401 W N Blvd
Leesburg, FL 34748-5044
Phone (352) 728-4242

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions76
Removal or shaving of skin growth1-10
Skin biopsy12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Florida Primary Care PA Internal Medicine CurrentSince Apr 1, 2002 Accepting new patients
Mid-Florida Primary Care PA Internal Medicine CurrentSince Apr 1, 2002 Accepting new patients
Mid-Florida Primary Care Past Accepting new patients
Central Florida Medical Partners, LLC Internal Medicine PastSince Sep 1, 2012 Accepting new patients

Locations

401 W North Blvd
Leesburg, FL 34748
Phone (352) 728-4242

501 E North Blvd
Leesburg, FL 34748
Phone (352) 431-3743

17809 SE 109th Ave
Summerfield, FL 34491
Phone (352) 307-4200

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rgupta563685@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1922077338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NORTH BLVD W",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485044",
            "telephone_number": "352-728-4242",
            "fax_number": "352-728-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NORTH BLVD W",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485044",
            "telephone_number": "352-728-4242",
            "fax_number": "352-728-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "RAVI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.