MEDICARE: DR. KRISHNA GOPAL GUPTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MD020901E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1008641	OTHER	GATEWAY HEALTH PLAN
2	94179	OTHER	HEALTH AMERICA
3	000000064297	OTHER	MEDPLUS
4	000000064297	OTHER	THREE RIVERS HEALTH PL
5	0000039578	OTHER	HIGHMARK BCBS
6	0000039578	OTHER	PA BLUE SHIELD
7	77801	OTHER	US HEALTHCARE
8	C28368	OTHER	UPMC FOR YOU
9	0000039578	OTHER	KEYSTONE HEALTH PLAN
10	94179	OTHER	HEALTH AMERICA ADVANTR
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	206878	OTHER	UPMC HEALTH PLAN
13	94179	OTHER	HEALTH ASSURANCE
14	25121574200	OTHER	OHIO BUREAU OF WORKERS
15	1061214	OTHER	WV WORKMENS

General Provider Information

NPI Number	:	1275526493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISHNA GOPAL GUPTA MD

Provider Business Mailing Address
First Line	:	251 7TH ST
Second Line	:	SUITE C202
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-6534
Country	:	US
Telephone Number	:	724-337-8404
Fax Number	:	724-337-4200

Provider Business Practice Location Address
First Line	:	251 7TH ST
Second Line	:	SUITE C202
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-6534
Country	:	US
Telephone Number	:	724-337-8404
Fax Number	:	724-337-4200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	07/08/2007

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