DR. MONIKA GUPTA M.D.
NPI 1073622072
Specialist in Newark, DE

Active since August 30, 2006PECOS EnrolledAccepts Medicare Assignment
94.71/100
CMS Quality Rating
314 E MAIN ST, 404 KELWAY PLAZA, NEWARK, DE 19711(302) 737-6041(302) 737-5598 Get Directions Write a Review

NPPES record last updated: April 12, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Monika Gupta M.d. NPPES

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

DR. MONIKA GUPTA M.D. (NPI 1073622072) is an individual specialist in Newark, Delaware, licensed in Delaware (C10008120) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1073622072
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. MONIKA GUPTACredential: M.D.
Location Address314 E MAIN ST, 404 KELWAY PLAZANewark, DE 19711-7128
Mailing Address314 E Main St, 404 Kelway PlazaNewark, DE 19711-7128 · (302) 737-6041 · Fax (302) 737-5598
Fax(302) 737-5598
Sole ProprietorYes
Medical School CMSOtherGraduated 1999
Enumeration DateAugust 30, 2006
Last NPPES UpdateApril 12, 2013
NPI 1073622072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in DE · C10008120
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

314 E MAIN ST, Newark, DE 19711

Other Identifiers 3

Medicaid1073622072DE
Medicare PIN492160DE
Other205465821DE · Blue Cross Blue Shield Of Delaware

Accepted 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. Monika 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 ID2264534544
PECOS Enrollment IDI20070219000090
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 6

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.
637 services300 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.
361 services230 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
245 services245 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.
23 services23 patients
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402
An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
18 services18 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
17 services17 patients

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.

94.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Promoting Interoperability90
Improvement Activities40
Cost90.7

Reported Quality Measures

Breast Cancer Screening
87%462 patients4/55-star benchmark: 93%
Colorectal Cancer Screening
59%1,067 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
99%591 patients5/55-star benchmark: 91%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
7%376 patients5/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%5,742 patients5/55-star benchmark: 100%
e-Prescribing
100%11,460 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
94%541 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
100%2,110 patients5/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
100%1,823 patients5/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 100% · 1,667 patients
Patients screened: 100% · 1,667 patients
100%117 patients5/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
61%2,140 patients3/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 3% · 573 patients
Patients totalRate: 5% · 573 patients
4%573 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 20

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

Ophthalmology
314 E MAIN ST
NEWARK, DE 19711
Specialist
314 E MAIN ST, STE. 402, KELWAY PLAZA
NEWARK, DE 19711
Ophthalmology
314 E MAIN ST, KELWAY PLAZA, SUITE 302
NEWARK, DE 19711
Psychologist
314 E MAIN ST, SUITE 104
NEWARK, DE 19711
Family Medicine
314 E MAIN ST, 404 KELWAY PLAZA
NEWARK, DE 19711
Licensed Practical Nurse
314 E MAIN ST, SUITE 101 KELWAY PLAZA
NEWARK, DE 19711
Internal Medicine
314 E MAIN ST, SUITE 103
NEWARK, DE 19711
Internal Medicine
314 E MAIN ST, SUITE 103
NEWARK, DE 19711

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 Monika Gupta's NPI number?

The NPI number for Monika Gupta is 1073622072. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Monika Gupta located?

Monika Gupta practices at 314 E Main St 404 Kelway Plaza, Newark, DE 19711. The listed phone number is (302) 737-6041.

What is Monika Gupta's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Monika Gupta enrolled in Medicare?

Yes. Monika 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 Monika Gupta accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Monika 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 Monika Gupta was last updated on April 12, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.