Sandhya Gupta, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9409 Issued in GA

Practice address

755 Walther Rd
Lawrenceville, GA 30046-8725

Phone

(678) 272-3699

Fax

(770) 290-8084

NPI assigned

Aug 14, 2019

Last updated

Mar 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside CV Professional Services LLCGroup PAC ID 4880003771, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score

76.66 of 100Reported as group

Quality

58.46

Promoting interoperability

83

Improvement activities

40

Cost

77.92

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Northside CV Professional Services LLC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1821612938
  Medicare reassignment Care Compare group NPD
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  NPD

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

• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1952957052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "678-272-3699",
            "fax_number": "770-290-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "678-272-3699",
            "fax_number": "770-290-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SANDHYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9409",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "9409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1160403",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MEDICAL COMPOSITE BOARD",
            "identifier": "9409",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raven Gunn, M.S, CCC- SLP
• Danielle Marie Gunnin
• Smart Guobadia
• Arulita Gupta
• Dave Raj Gupta, M.P.H
• Yelitza Mari Guzman, ACGNP-BC
• Gwinnett Anesthesia Service PC
• Gwinnett Cardiology Services LLC
• Gwinnett Center for Oral & Maxillofacial Surgery LLC
• Gwinnett Center Medical Associates

• Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.