Shashvat Gupta, M.D.

Key facts

NPI

1972058717

Entity type

Individual (NPI type 1)

Primary specialty

Hospitalist Physician 208M00000X

License

63536 (CT)

Practice address

20 York Street, CB-2041
New Havven, CT 06510

Phone

(203) 688-1734

Fax

(203) 688-4740

NPI assigned

Aug 22, 2016

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Northeast Medical Group, Inc. Internal Medicine Physician · Bridgeport, CT · NPI 1043278351
  Medicare reassignment Care Compare group NPD CT

Hospital & facility affiliations 2

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

• Yale New Haven Hospital General Acute Care Hospital · New Haven, CT · NPI 1336139500
  Care Compare affiliation Hospital
• Yale New Haven Hospital General Acute Care Hospital · New Haven, CT · NPI 1578778726
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Hospitalist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Medical Group Inc (1,357 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital · New Haven, CT · CCN 070022

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100 (apm)

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgupta429523@direct.ynhh.org

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 10, 2019.

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1972058717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-1734",
            "fax_number": "203-688-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-688-1734",
            "fax_number": "203-688-4740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_2": "PMB-488",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-6613 x6613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Woods Rd",
            "address_2": "PMB-488",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-6613 x6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SHASHVAT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "63536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}