Physician Compare National (NPI:1225089725)

HEALTHCARE PROVIDER: RAJEEV GUPTA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1225089725
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022150515
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100217000594
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUPTA
	Individual professional last name
Provider First Name	RAJEEV
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PRIMARY CARE AND GERIATRICS, PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3577605054
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	711 MCFARLAND ST
	Group Practice or individual's line 1 address
City	MORRISTOWN
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	378143977
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4233177412
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440030
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	440056
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	440153
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NEWPORT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	440032
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y