Individual provider Active NPI

Ashish K Gupta, MD

  • Vascular Surgery Physician
  • Panama City, FL
National Provider Identifier
1942390729
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME113628 Issued in FL
Practice address
1399 Jenks Ave # 12
Panama City, FL 32401-2442
Phone
(850) 532-6303
Fax
(850) 307-5402
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME113628 FL Primary

Addresses

Primary practice location

1399 Jenks Ave # 12
Panama City, FL 32401-2442

Mailing address

1399 Jenks Ave # 12
Panama City, FL 32401-2442
Phone (850) 532-6303

Other identifiers 3

IdentifierTypeStateIssuer
010517300MedicaidFL
31895OtherFLFLORIDA BLUE
P01249310OtherFLRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120829000700 FL Practitioner - Vascular Surgery 9133222425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Morehouse School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1399 Jenks Ave
Suite 12
Panama City, FL 32401-2596
Phone (850) 532-6303

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
95.52
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal67
Leg revascularization (restoring blood flow)28
Removal of tissue181

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Vascular of Panama City PLLC Vascular Surgery CurrentSince Nov 1, 2013 Accepting new patients
Lambert, Klamer and Gupta, PSC Vascular Surgery Past Accepting new patients

Locations

1399 Jenks Ave
Ste 12
Panama City, FL 32401

1399 Jenks Ave
#12
Panama City, FL 32401
Phone (850) 532-6303

10800 Panama City Beach Pkwy
Ste 300
Panama City Beach, FL 32407
Phone (850) 250-2637

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GICECA/Endpoint/GICECA
  • FHIR API: https://fhir4.healow.com/fhir/r4/GICECA

Organizations & group practices 2

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 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1942390729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 JENKS AVE # 12",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012442",
            "telephone_number": "850-532-6303",
            "fax_number": "850-307-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 JENKS AVE # 12",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012442",
            "telephone_number": "850-532-6303",
            "fax_number": "850-307-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ASHISH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME113628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010517300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "31895",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01249310",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.