{
"Npi": {
"NPI": "1699117101",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GUPTA",
"FirstName": "SAMEER",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3000 ARLINGTON AVE STOP 1108",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TOLEDO",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43614-2595",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3131 E CLARENDON AVE STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85016-7069",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-253-9168",
"PracticeLocationAddressFaxNumber": "602-251-3126",
"EnumerationDate": "07/25/2013",
"LastUpdateDate": "01/21/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "208G00000X",
"TaxonomyName": "Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician",
"LicenseNumber": "35C.000928",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2086S0102X",
"TaxonomyName": "Surgical Critical Care Physician",
"LicenseNumber": "35C.000928",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2086S0102X",
"TaxonomyName": "Surgical Critical Care Physician",
"LicenseNumber": "036135491",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208G00000X",
"TaxonomyName": "Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician",
"LicenseNumber": "76030",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}