Physician Compare National (NPI:1366511545)

HEALTHCARE PROVIDER: KALPANA JAIN GUPTA M.D.

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

Individual Professional Information
NPI	1366511545
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648167221
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110628000195
	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	KALPANA
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	500 W MEDICAL CTR BLVD
	Group Practice or individual's line 1 address
City	WEBSTER
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	775984220
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450617
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CLEAR LAKE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450184
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL HERMANN HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450709
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOUSTON METHODIST ST JOHN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M