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DR. BAL KRISHAN GUPTA MD
NPI 1225041353
Psychiatry & Neurology - Psychiatry in Warren, MI

Active since August 13, 2006PECOS EnrolledAccepts Medicare Assignment
78.31/100
CMS Quality Rating
11900 E TWELVE MILE RD, SUITE 111, WARREN, MI 48093(586) 573-5300(586) 573-5304 Get Directions Write a Review

NPPES record last updated: April 22, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Bal Krishan Gupta Md NPPES

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

DR. BAL KRISHAN GUPTA MD (NPI 1225041353) is an individual psychiatry provider in Warren, Michigan, licensed in Michigan (4301037633) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Macomb Oakland Hosp-warren Campus, and is a graduate of Other (1970).

NPPES Registry Identity

NPI1225041353
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. BAL KRISHAN GUPTACredential: MD
Location Address11900 E TWELVE MILE RD, SUITE 111Warren, MI 48093-3472
Mailing Address11900 E Twelve Mile Rd, Suite 111Warren, MI 48093-3472 · (586) 573-5300 · Fax (586) 573-5304
Phone(586) 573-5300
Fax(586) 573-5304
Sole ProprietorNo
Medical School CMSOtherGraduated 1970
Enumeration DateAugust 13, 2006
Last NPPES UpdateApril 22, 2014
✔ NPI 1225041353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in MI · 4301037633
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedPsychiatry & Neurology · Forensic PsychiatryTaxonomy 2084F0202X · License 4301037633 (MI)
11900 E TWELVE MILE RD, Warren, MI 48093
Open in Google Maps ↗

Other Identifiers 5

Medicaid1368788MI
Medicare ID-Type UnspecifiedOM57830Group
Other260E011140Bcbs
Medicare UPINE21190
Medicare ID-Type Unspecified08215790261

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.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. Bal Krishan 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 ID1557315546
PECOS Enrollment IDI20110325000862
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 5

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.
1,017 services108 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
371 services29 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
74 services27 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
67 services26 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
24 services24 patients

Hospital Affiliations CMS Care Compare

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

Ascension Macomb Oakland Hosp-Warren Campus

Acute Care Hospitals · Warren, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230195
Location11800 East Twelve Mile RoadWarren, MI 48093 · Macomb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48093 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
$177.36 typical visit price
range $58.04 – $177.36
Typical copayment $44.34 (range $14.51 – $44.34)
Most-billed visit code 99205
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

78.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality51.11
Promoting Interoperability84
Improvement Activities40

Other Providers at the Same Location NPPES

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

BAL K GUPTA MD PC
Psychiatry & Neurology (Psychiatry)
11900 E TWELVE MILE RD, SUITE 111
WARREN, MI 48093
Macomb County (586) 573-5300

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 Bal Gupta's NPI number?

The NPI number for Bal Gupta is 1225041353. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Where is Bal Gupta located?

Bal Gupta practices at 11900 E Twelve Mile Rd Suite 111, Warren, MI 48093. The listed phone number is (586) 573-5300.

What is Bal Gupta's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Bal Gupta enrolled in Medicare?

Yes. Bal 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 Bal Gupta accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and Providence Health Plan list Bal 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 Bal Gupta affiliated with any hospitals?

According to CMS data, Bal Gupta is affiliated with Ascension Macomb Oakland Hosp-Warren Campus.

When was this NPI record last updated?

The NPPES record for Bal Gupta was last updated on April 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.