Individual provider Active NPI

Priyanka Gupta, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1962694307
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
002876 Issued in NY
Practice address
3410-18 Broadway
2ND Floor
New York, NY 10031
Phone
(212) 283-2099
Fax
(212) 234-2939
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 002876 NY Primary

Addresses

Primary practice location

3410-18 Broadway
2ND Floor
New York, NY 10031

Mailing address

3410 Broadway
2ND Floor
New York, NY 10031
Phone (212) 283-2099

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
I20161028000841 NY Practitioner - Pediatric Medicine 0648558486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Medical Healthcare Associates PLLCGroup PAC ID 9032541768, 10 clinicians

Practice addresses (Care Compare)

3410 Broadway
Ofc 2
New York, NY 10031-7408
Phone (212) 283-2099

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002876NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical Healthcare Associates PLLC CurrentSince Nov 1, 2019 Accepting new patients
Shirish Patel Medical P.C. PastSince Dec 2, 2010 Accepting new patients

Locations

2742 3rd Ave
Bronx, NY 10455
Phone (718) 576-5049

2802 Crescent St
Long Island City, NY 11102
Phone (718) 278-6666

3410 Broadway
Frnt 2
New York, NY 10031
Phone (212) 283-1900

3418 Broadway
Ofc 2
New York, NY 10031
Phone (212) 927-0013

565 W 125th St
New York, NY 10027
Phone (212) 470-1000

3410 Broadway
New York, NY 10031
Phone (201) 299-4758

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: priyanka.gupta@cmhap.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1962694307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10031",
            "telephone_number": "212-283-2099",
            "fax_number": "212-234-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410-18 BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10031",
            "telephone_number": "212-283-2099",
            "fax_number": "212-234-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRIYANKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "002876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.