Physician Compare National (NPI:1730183401)

HEALTHCARE PROVIDER: SHAMINDER MOHAN 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	1730183401
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658322300
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050210000022
	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	SHAMINDER
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	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	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	701 METAIRIE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2A202
	Group Practice or individual's line 2 address
City	METAIRIE
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	700054044
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190183
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LEONARD J CHABERT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190036
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	OCHSNER MEDICAL CENTER NEW ORLEANS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	190008
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TERREBONNE GENERAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y