DEBRA L. GUPTA MD
NPI 1134170848
Family Medicine in Pairie Village, KS

NPI Status: Active since May 15, 2006

Contact Information

5250 W 94TH TERRACE
PAIRIE VILLAGE, KS
ZIP 66207
Phone: (913) 780-0030
Fax: (913) 782-2924

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  • Individual
  • Female
  • Family Medicine
  • Accepts Insurance
  • PECOS Enrolled
  • Opted-Out Medicare

About DEBRA GUPTA

This page provides the complete NPI Profile along with additional information for Debra Gupta, a primary care provider established in Pairie Village, Kansas with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1134170848 assigned on May 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 0424531 (KS). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1134170848
Provider Name
DEBRA L. GUPTA MD
Gender
Female
Entity Type
Individual
Location Address
5250 W 94TH TERRACE PAIRIE VILLAGE, KS 66207
Location Phone
(913) 780-0030
Location Fax
(913) 782-2924
Mailing Address
5250 W 94TH TERRACE PRAIRIE VILLAGE, KS 66207
Mailing Phone
(913) 451-0000
Mailing Fax
(913) 491-0547
Is Sole Proprietor?
No
Enumeration Date
05-15-2006
Last Update Date
03-16-2016
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A primary care provider (PCP) like Debra Gupta sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Debra Gupta opted out of Medicare effective on 10-12-2017 until 10-12-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
0424531
License State
KS
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue KC Catastrophic BlueSelect EPO - EPO
  • Blue KC Choice Bronze 2 with Spira Care BlueSelect EPO - EPO
  • Blue KC Choice Silver 1 with Spira Care BlueSelect EPO - EPO
  • Blue KC Community Silver Preferred-Care Blue EPO - EPO
  • Blue KC First Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Standard Bronze BlueSelect EPO - EPO
  • Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Standard Gold BlueSelect EPO - EPO
  • Blue KC Standard Gold Preferred-Care Blue EPO - EPO
  • Blue KC Standard Silver BlueSelect EPO - EPO
  • Blue KC Standard Silver Preferred-Care Blue EPO - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
F70574MEDICARE UPIN (02) 
0338024DMEDICARE ID-TYPE UNSPECIFIED (04)KS 
100152300BMEDICAID (05)KS 

Medicare Participation & PECOS Enrollment Status

Debra Gupta is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 10-12-2017

  • Opt-Out End Date: 10-12-2027

  • Eligible to Order and Refer? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 66207 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.98
  • Minimum New Patient Price $53
  • Maximum New Patient Price $161.67
  • Average New Patient Copayment $20.49
  • Minimum New Patient Copayment $13.25
  • Maximum New Patient Copayment $40.41

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.12
  • Minimum Established Patient Price $16.88
  • Maximum Established Patient Price $132.11
  • Average Established Patient Copayment $23.53
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $33.02

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134170848, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
0
Doubled → 0
Pos 8
8
Unchanged
Pos 9
4
Doubled → 8
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 1 → 2 0 → 0 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 2 + 7 + 0 + 8 + 8 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1134170848.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
5250 W 94TH TERRACE
PAIRIE VILLAGE, KS 66207
Orthopaedic Surgery
5250 W 94TH TERRACE
PAIRIE VILLAGE, KS 66207

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134170848, enumerated as an "individual" on May 15, 2006.

The provider is located at 5250 W 94TH TERRACE PAIRIE VILLAGE, KS 66207 and the phone number is (913) 780-0030.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Kansas City,. Please consult your insurance carrier or call the provider to verify.