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DR. MADHU GUPTA M.D.
NPI 1265628473
Family Medicine in Walnut Creek, CA

Active since September 20, 2007PECOS EnrolledAccepts Medicare Assignment
91.01/100
CMS Quality Rating
1450 TREAT BLVD, SUITE 120A, WALNUT CREEK, CA 94597(925) 296-9727(925) 296-9032 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Madhu Gupta M.d. NPPES

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

DR. MADHU GUPTA M.D. (NPI 1265628473) is an individual family medicine provider in Walnut Creek, California, licensed in California (A101257) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1986).

NPPES Registry Identity

NPI1265628473
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MADHU GUPTACredential: M.D.
Location Address1450 TREAT BLVD, SUITE 120AWalnut Creek, CA 94597-2168
Mailing AddressDept 34929, P.o. Box 39000San Francisco, CA 94139-0001 · (925) 952-2828 · Fax (925) 952-2850
Phone(925) 296-9727
Fax(925) 296-9032
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateSeptember 20, 2007
Last NPPES UpdateMarch 7, 2023
✔ NPI 1265628473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A101257
Definition

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.

1450 TREAT BLVD, Walnut Creek, CA 94597
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Other Identifiers 1

OtherP01451509CA · Railroad Medicare

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. Madhu 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 ID6002980554
PECOS Enrollment IDI20080801000351
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.
229 services128 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.
100 services84 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.
67 services67 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.
25 services25 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
23 services23 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94597 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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.

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.

91.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality97.04
Promoting Interoperability100
Improvement Activities40
Cost68.1

Reported Quality Measures

Appropriate Testing for Pharyngitis
97%29 patients4/55-star benchmark: 100%
Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
2%129 patients
Breast Cancer Screening
79%316 patients4/55-star benchmark: 93%
Cervical Cancer Screening
56%713 patients3/55-star benchmark: 98%
Chlamydia Screening for Women
45%51 patients
Colorectal Cancer Screening
63%701 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
84%348 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
25%143 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
22%143 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%2,869 patients5/55-star benchmark: 100%
e-Prescribing
100%1,106 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
63%287 patients3/55-star benchmark: 100%
HIV Screening
22%1,295 patients2/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
51%1,355 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
71%1,232 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 76% · 999 patients
Patients screened: 79% · 999 patients
14%35 patients1/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
99%635 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
77%302 patients4/55-star benchmark: 91%
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers15 claims27 services$6.15 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
2 suppliers14 claims14 services$66.93 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.

DR. PURNIMA G KUDLU M.D.
Pediatrics
1450 TREAT BLVD, SUITE 140
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9784
DR. DEVORAH E BEN-ZEEV M.D.
Internal Medicine
1450 TREAT BLVD, SUITE 120A
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9720
DR. JOHN T CHO M.D.
Family Medicine
1450 TREAT BLVD, SUITE 120B
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9720
DR. DEBORAH A GREER M.D.
Family Medicine
1450 TREAT BLVD, SUITE 160
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9000
DR. ELISE M. HUGHES-WATKINS M.D.
Internal Medicine
1450 TREAT BLVD, SUITE 250B
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9740
DR. ARTHUR K. LAW M.D.
Pediatrics
1450 TREAT BLVD, SUITE 140
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9770
DR. TIEN H LAM M.D.
Family Medicine
1450 TREAT BLVD, SUITE 120B
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9720
DR. TESSIE A OKAMURA M.D.
Pediatrics
1450 TREAT BLVD, SUITE 140
WALNUT CREEK, CA 94597
Contra Costa County (925) 296-9770

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 Madhu Gupta's NPI number?

The NPI number for Madhu Gupta is 1265628473. It was assigned to this individual provider in the NPPES registry on September 20, 2007.

Where is Madhu Gupta located?

Madhu Gupta practices at 1450 Treat Blvd Suite 120A, Walnut Creek, CA 94597. The listed phone number is (925) 296-9727.

What is Madhu Gupta's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Madhu Gupta enrolled in Medicare?

Yes. Madhu 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.

When was this NPI record last updated?

The NPPES record for Madhu Gupta was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.