NILESH I GUPTA M.D.
NPI 1255363636
Internal Medicine - Pulmonary Disease in Menomonee Falls, WI

Q: What is Nilesh Gupta's NPI number?

The NPI number for Nilesh Gupta is 1255363636. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Q: What is Nilesh Gupta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Nilesh Gupta was last updated on April 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 07, 2006PECOS EnrolledAccepts Medicare Assignment

N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051(262) 251-7500(262) 251-7128 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 1, 2024, Nov 23, 2021, Jun 21, 2018 (3 updates tracked since 2018).

On this page

About Nilesh I Gupta M.d. NPPES

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

NILESH I GUPTA M.D. (NPI 1255363636) is an individual pulmonary disease provider in Menomonee Falls, Wisconsin, licensed in Wisconsin (43436) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Aurora Medical Ctr Washington County, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1255363636

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameNILESH I GUPTACredential: M.D.

Location AddressN84W16889 MENOMONEE AVEMenomonee Falls, WI 53051

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(262) 251-7500

Fax(262) 251-7128

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateJuly 7, 2006

Last NPPES UpdateApril 1, 20243 updates tracked since enumeration

NPPES CertifiedApril 1, 2024

✔ NPI 1255363636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in WI · 43436

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 43436 (WI)

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 43436 (WI)

N84W16889 MENOMONEE AVE, Menomonee Falls, WI 53051

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Other Identifiers 2

Medicaid34636700WI

OtherP00460100WI · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) 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

Nilesh I 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 ID9638113863

PECOS Enrollment IDI20050617000387

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 11

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.

254 services203 patients

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

Albuterol is a medication used to treat breathing problems. It is administered as an inhalation solution through a device called DME (Durable Medical Equipment). The solution is FDA-approved and non-compounded. Each unit dose contains 1 mg of the medicine.

216 services71 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

94 services94 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

86 services86 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

82 services82 patients

Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg J7614

Levalbuterol is a medication used to treat breathing difficulties like those experienced in asthma. It's administered via a device called a nebulizer, which turns the solution into a fine mist for you to inhale. Each dose contains 0.5 mg of the medication.

39 services13 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

Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811

A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.

19 services18 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

18 services18 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.

14 services13 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Aurora Medical Ctr Washington County

Acute Care Hospitals · Hartford, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520038

Location1032 E Sumner StHartford, WI 53027 · Washington County

Emergency services

Community Memorial Hospital

Acute Care Hospitals · Menomonee Falls, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520103

LocationW180 N8085 Town Hall RdMenomonee Falls, WI 53051 · Waukesha County

Emergency services

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520138

Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County

Emergency services Birthing friendly

West Allis Memorial Hospital

Acute Care Hospitals · West Allis, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520139

Location8901 W Lincoln AveWest Allis, WI 53227 · Milwaukee County

Emergency services Birthing friendly

Aurora Medical Center - Summit

Acute Care Hospitals · Summit, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520206

Location36500 Aurora DriveSummit, WI 53066 · Waukesha County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53051 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

Referred Medical Equipment & Supplies CMS DME claims 26

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

10 suppliers159 claims159 services$32.18 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

2 suppliers14 claims28 services$1.29 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

7 suppliers127 claims127 services$66.05 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

6 suppliers131 claims335 services$26.36 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

11 suppliers96 claims526 services$13.83 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

4 suppliers64 claims353 services$12.24 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

13 suppliers169 claims169 services$43.38 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

13 suppliers195 claims195 services$14.92 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

8 suppliers120 claims120 services$8.77 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

14 suppliers277 claims1,504 services$1.56 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

4 suppliers13 claims13 services$5.11 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

8 suppliers133 claims133 services$11.21 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers39 claims41 services$17.01 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$789.59 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

2 suppliers13 claims13 services$66.86 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0471

DME-Other DME · category DE001N

2 suppliers11 claims11 services$182.59 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

6 suppliers13 claims13 services$118.47 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

2 suppliers118 claims118 services$10.58 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers36 claims36 services$3.35 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

8 suppliers231 claims231 services$26.71 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers136 claims136 services$65.56 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers58 claims59 services$29.99 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

2 suppliers22 claims1,230 services$4.59 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

7 suppliers41 claims3,135 services$0.08 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

1 supplier12 claims720 services$0.82 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

8 suppliers48 claims48 services$23.35 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ROXANNE PHELPS O.D.

Optometrist

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

GARY W. STEWART M.D.

Surgery

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

JANELL R SCHULTEIS-WILSON M.D.

Family Medicine

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

ASHLEY POLOMIS MS, CCC-SLP

Speech-Language Pathologist

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

ELIZABETH PECHSTEIN PA-C

Physician Assistant

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

DAVID J. LUBER NP

Nurse Practitioner

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

THOMAS P. HEYRMAN M.D.

Ophthalmology

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

STEPHANIE J. ECKSTEIN P.T.

Physical Therapist

N84W16889 MENOMONEE AVE
MENOMONEE FALLS, WI 53051

Waukesha County (262) 251-7500

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 Nilesh Gupta's NPI number?

The NPI number for Nilesh Gupta is 1255363636. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Nilesh Gupta located?

Nilesh Gupta practices at N84w16889 Menomonee Ave, Menomonee Falls, WI 53051. The listed phone number is (262) 251-7500.

What is Nilesh Gupta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Nilesh Gupta enrolled in Medicare?

Yes. Nilesh 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 Nilesh Gupta accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Quartz and 1 other insurer list Nilesh 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 Nilesh Gupta affiliated with any hospitals?

According to CMS data, Nilesh Gupta is affiliated with Aurora Medical Ctr Washington County, Community Memorial Hospital, Aurora St Lukes Medical Center, West Allis Memorial Hospital and Aurora Medical Center - Summit.

When was this NPI record last updated?

The NPPES record for Nilesh Gupta was last updated on April 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.