Individual provider Active NPI

Shailvi Gupta, MD

  • Trauma Surgery Physician
  • Oakland, CA
National Provider Identifier
1942521349
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
D0085996 Issued in MD
Practice address
1411 E 31St St
Oakland, CA 94602-1018
Phone
(510) 437-4965
Fax
(510) 437-5127
NPI assigned
Jun 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0102X D0085996 MD
Trauma Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0127X D0085996 MD Primary

Addresses

Primary practice location

1411 E 31St St
Oakland, CA 94602-1018

Mailing address

22 S Greene St
Baltimore, MD 21201-1544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181226000093 MD Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 8921396938 Reassigns benefits to 1 organization
I20190417002245 DC Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 8921396938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Geisel School of Medicine at Dartmouth, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shock Trauma Associates PAGroup PAC ID 6800882317, 258 clinicians

Practice addresses (Care Compare)

110 S Paca St
Box 38
Baltimore, MD 21201-1642

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

250 W Pratt St
Suite 800
Baltimore, MD 21201-2500

250 W Pratt St
Suite 900
Baltimore, MD 21201-6808

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0085996MDMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dimensions Healthcare Associates, Inc. Multi-Specialty Current Accepting new patients
Dimensions Health Associates Dba University of Maryland Capital Region Multi-Specialty CurrentSince Mar 20, 2019 Accepting new patients
Dimensions Healthcare Associates Inc Multi-Specialty CurrentSince Mar 20, 2019 Accepting new patients
Shock Trauma Associates, P.a. Multi-Specialty CurrentSince Nov 1, 2018 Accepting new patients
University of Maryland Medical Center, LLC Multi-Specialty Past Accepting new patients

Locations

110 S Paca St
#38
Baltimore, MD 21201

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Interoperability endpoints

  • Direct secure messaging: sgupta481972@direct.umm.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1942521349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4965",
            "fax_number": "510-437-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SHAILVI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-20",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MD",
            "license": "D0085996",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "MD",
            "license": "D0085996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.