DR. JIWAN P GUPTA M.D.
NPI 1053305458
General Practice in Irvine, CA

Active since August 31, 2005PECOS Enrolled
14795 JEFFREY RD STE 204, IRVINE, CA 92618(949) 486-4411 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 13, 2021, Mar 3, 2021, Aug 2, 2018 (3 updates tracked since 2018).

About Dr. Jiwan P Gupta M.d. NPPES

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

DR. JIWAN P GUPTA M.D. (NPI 1053305458) is an individual general practice provider in Irvine, California, licensed in California (A37323) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mission Viejo.

NPPES Registry Identity

NPI1053305458
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. JIWAN P GUPTACredential: M.D.
Location Address14795 JEFFREY RD STE 204Irvine, CA 92618-0417
Mailing Address33 MontgomeryMission Viejo, CA 92692-5115 · (949) 648-3878 · Fax (949) 486-4417
Sole ProprietorYes
Enumeration DateAugust 31, 2005
Last NPPES UpdateMay 13, 20213 updates tracked since enumeration
NPPES CertifiedMay 13, 2021
NPI 1053305458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License Licensed in CA · A37323
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedAnesthesiologyTaxonomy 207L00000X · License A37323 (CA)
Also ListedClinic/Center · Occupational MedicineTaxonomy 261QX0100X · License A37323 (CA)
14795 JEFFREY RD STE 204, Irvine, CA 92618

Secondary Practice Location 1

Location 133 MontgomeryMission Viejo, CA 92692-5115 · Phone (949) 648-3878

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jiwan P Gupta M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES

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

Chiropractor
14795 JEFFREY RD STE 204
IRVINE, CA 92618

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053305458, enumerated as an "individual" on August 31, 2005.

The provider is located at 14795 JEFFREY RD STE 204 IRVINE, CA 92618 and the phone number is (949) 486-4411.

General Practice with taxonomy code 208D00000X.