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DR. PRASHANT GUPTA M.D.
NPI 1043552862
Family Medicine in Burien, WA

Active since March 19, 2013PECOS EnrolledAccepts Medicare Assignment
16045 1ST AVE S # F1, BURIEN, WA 98148(206) 965-4180(206) 965-4199 Get Directions Write a Review

NPPES record last updated: July 10, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 10, 2019, Sep 1, 2016, Jun 27, 2016 (3 updates tracked since 2016).

About Dr. Prashant Gupta M.d. NPPES

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

DR. PRASHANT GUPTA M.D. (NPI 1043552862) is an individual family medicine provider in Burien, Washington, licensed in Washington (60660929) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, is affiliated with Evergreenhealth Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1043552862
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PRASHANT GUPTACredential: M.D.
Location Address16045 1ST AVE S # F1Burien, WA 98148
Mailing Address16045 1st Ave S # F1Burien, WA 98148-1401 · (206) 965-4180 · Fax (206) 965-4199
Phone(206) 965-4180
Fax(206) 965-4199
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 19, 2013
Last NPPES UpdateJuly 10, 20193 updates tracked since enumeration
✔ NPI 1043552862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in WA · 60660929✔ Licensed in IL · 036138919
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
16045 1ST AVE S # F1, Burien, WA 98148
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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. Prashant Gupta M.d. 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 ID6507161858
PECOS Enrollment IDI20160920000706
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 10

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 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.
72 services71 patients
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.
48 services46 patients
Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected 0241U
This test detects the RNA of respiratory viruses, including COVID-19, Influenza A, Influenza B, and Respiratory Syncytial Virus, in an upper respiratory specimen. The test result will report if each virus is detected or not, helping in accurate diagnosis.
37 services36 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
36 services35 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.
34 services34 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
33 services33 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Evergreenhealth Medical Center

Acute Care Hospitals · Kirkland, WA
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500124
Location12040 NE 128th StreetKirkland, WA 98034 · King County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98148 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
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Prashant Gupta's NPI number?

The NPI number for Prashant Gupta is 1043552862. It was assigned to this individual provider in the NPPES registry on March 19, 2013.

Where is Prashant Gupta located?

Prashant Gupta practices at 16045 1st Ave S # F1, Burien, WA 98148. The listed phone number is (206) 965-4180.

What is Prashant Gupta's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Prashant Gupta enrolled in Medicare?

Yes. Prashant 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 Prashant Gupta accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Prashant 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.

Is Prashant Gupta affiliated with any hospitals?

According to CMS data, Prashant Gupta is affiliated with Evergreenhealth Medical Center.

When was this NPI record last updated?

The NPPES record for Prashant Gupta was last updated on July 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.