Organization Active NPI

Simhadri M Gupta MD LLC

  • Neurology Physician
  • Edison, NJ
National Provider Identifier
1982659223
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA06573700 Issued in NJ
Legal business name
SIMHADRI M GUPTA MD LLC
Practice address
2 Lincoln Hwy
Suite 302
Edison, NJ 08820-3961
Phone
(732) 421-8422
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Dr. Simhadri M Gupta, MDNPI 1760483895
Title
Owner
Phone
(732) 421-8422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 25MA06573700 NJ Primary

Addresses

Primary practice location

2 Lincoln Hwy
Suite 302
Edison, NJ 08820-3961

Mailing address

PO Box 897
Piscataway, NJ 08855-0897
Phone (201) 512-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060118000617 NJ Part B Supplier - Clinic/Group Practice 7315961299 Receives reassigned benefits from 1 practitioner
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

2 Lincoln Hwy
Ste 100A
Edison, NJ 08820
Phone (732) 548-1770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1982659223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088550897",
            "telephone_number": "201-512-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY",
            "address_2": "SUITE 302",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-421-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMHADRI M GUPTA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SIMHADRI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-421-8422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA06573700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.