Individual provider Active NPI

Amita Gupta, MD

  • Internal Medicine Physician
  • Chandler, AZ
National Provider Identifier
1962462630
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33008 Issued in AZ
Practice address
2075 W Pecos Rd, #2
Chandler, AZ 85224-5693
Phone
(480) 219-6840
Fax
(480) 219-6841
NPI assigned
Mar 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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 33008 AZ Primary

Addresses

Primary practice location

2075 W Pecos Rd, #2
Chandler, AZ 85224-5693

Mailing address

2075 W Pecos Rd
Suite 2
Chandler, AZ 85224-5722
Phone (480) 219-6840

Other identifiers 3

IdentifierTypeStateIssuer
AZ0759120OtherAZBC/BS OF AZ
P00279971OtherAZRR MEDICARE
866973MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040803000124 AZ Practitioner - Internal Medicine 4082685201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ravi Gupta MD PLLCGroup PAC ID 5092870873, 2 clinicians

Practice addresses (Care Compare)

2075 W Pecos Rd
Suite 2
Chandler, AZ 85224-5723
Phone (480) 219-6840

Hospital & facility affiliations

  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33008AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ravi Gupta, MD, PLLC Internal Medicine CurrentSince Mar 15, 2009 Accepting new patients
Comprehensive Hospitalist Services of Arizona LLC Hospitalist Past Accepting new patients
Acclaimed Internal Medicine PLLC Hospitalist Past Accepting new patients
Comprehensive Hospitalist Services of Arizona, LLC Hospitalist Past Accepting new patients
Adam Internal Medicine PLLC Hospitalist Past Accepting new patients

Locations

2075 W Pecos Rd
Ste 2
Chandler, AZ 85224
Phone (480) 219-6840

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1962462630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 W PECOS RD",
            "address_2": "SUITE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245722",
            "telephone_number": "480-219-6840",
            "fax_number": "480-219-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W PECOS RD, #2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245693",
            "telephone_number": "480-219-6840",
            "fax_number": "480-219-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AMITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-25",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AZ",
            "identifier": "AZ0759120",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00279971",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "866973",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.