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DR. SANJAY K GUPTA MD
NPI 1043298870
Otolaryngology in Greeley, CO

Active since January 03, 2006PECOS EnrolledAccepts Medicare Assignment
83.62/100
CMS Quality Rating
6500 29TH STREET, SUITE 106, GREELEY, CO 80634(970) 330-5555(970) 584-1055 Get Directions Write a Review

NPPES record last updated: November 18, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Sanjay K Gupta Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SANJAY K GUPTA MD (NPI 1043298870) is an individual otolaryngology provider in Greeley, Colorado, licensed in Colorado (41311) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (1996).

NPPES Registry Identity

NPI1043298870
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. SANJAY K GUPTACredential: MD
Location Address6500 29TH STREET, SUITE 106Greeley, CO 80634-8386
Mailing Address6500 29th St, Suite 106Greeley, CO 80634-8386 · (970) 330-5555 · Fax (970) 584-1055
Phone(970) 330-5555
Fax(970) 584-1055
Sole ProprietorNo
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 1996
Enumeration DateJanuary 3, 2006
Last NPPES UpdateNovember 18, 2011
✔ NPI 1043298870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in CO · 41311
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
6500 29TH STREET, Greeley, CO 80634
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Other Identifiers 4

Medicare PINC494138CO
Medicare UPINF60795CO
Medicare ID-Type Unspecified494138CO
Medicaid80585019CO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sanjay K Gupta Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052494283
PECOS Enrollment IDI20090717000520
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
142 services108 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
110 services88 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
59 services59 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
58 services48 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
57 services47 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
56 services56 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80634 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$132.55 typical visit price
range $58.06 – $174.82
Typical copayment $33.13 (range $14.51 – $43.70)
Most-billed visit code 99204
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality80.73
Improvement Activities40

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use
69%42 patients
Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Lower rates are better for this measure.
37%95 patients3/55-star benchmark: 100%
Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)
100%35 patients
Non-Recommended Cervical Cancer Screening in Adolescent Females
Lower rates are better for this measure.
0%46 patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
100%1,100 patients5/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 100% · 459 patients
Patients screened: 100% · 459 patients
100%26 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
83%250 patients4/55-star benchmark: 98%
Tobacco Use and Help with Quitting Among Adolescents
96%135 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRONT RANGE ENT, PC
Otolaryngology
6500 29TH STREET, SUITE 106
GREELEY, CO 80634
Weld County (970) 330-5555
DR. JAMES SKORDAS AUD
Audiologist
6500 29TH STREET, SUITE 106
GREELEY, CO 80634
Weld County (970) 330-5555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sanjay Gupta's NPI number?

The NPI number for Sanjay Gupta is 1043298870. It was assigned to this individual provider in the NPPES registry on January 3, 2006.

Where is Sanjay Gupta located?

Sanjay Gupta practices at 6500 29th Street Suite 106, Greeley, CO 80634. The listed phone number is (970) 330-5555.

What is Sanjay Gupta's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Sanjay Gupta enrolled in Medicare?

Yes. Sanjay Gupta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sanjay Gupta accept?

Health plans from UnitedHealthcare list Sanjay Gupta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sanjay Gupta was last updated on November 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.