Individual provider Active NPI

Indu Gupta, MD, MPH, MAPA

  • Internal Medicine Physician
  • Cooperstown, NY
National Provider Identifier
1952585838
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
186651-1 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-4625
Fax
(607) 547-3259
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 186651-1 NY Primary
Internal Medicine Physician 207R00000X C54706 CA

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

421 Montgomery St. Onondaga County Health Department
John H. Mulroy Civic Center 9TH Floor
Syracuse, NY 13202
Phone (315) 435-3155

Other practice location 1

421 Montgomery St. Onondaga County Health Department
John H. Mulroy Civic Center 9th Floor
Syracuse, NY 13202
Phone (315) 435-3155

Other identifiers 1

IdentifierTypeStateIssuer
01274611MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050930000484 NY Practitioner - Internal Medicine 2365339645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
186651-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Dec 4, 2023 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Dec 4, 2023 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

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

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1952585838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MONTGOMERY ST. ONONDAGA COUNTY HEALTH DEPARTMENT",
            "address_2": "JOHN H. MULROY CIVIC CENTER 9TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13202",
            "telephone_number": "315-435-3155",
            "fax_number": "315-435-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-4625",
            "fax_number": "607-547-3259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Montgomery St. Onondaga County Health Department",
            "address_2": "John H. Mulroy Civic Center 9th Floor",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "13202",
            "country_code": "US",
            "telephone_number": "315-435-3155",
            "fax_number": "315-435-5720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "INDU",
        "name_prefix": "Dr.",
        "credential": "MD, MPH, MAPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "186651-1",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C54706",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01274611",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.