PANKAJ GUPTA MD
NPI 1306880992
Otolaryngology in Durham, NC

Q: What is Pankaj Gupta's NPI number?

The NPI number for Pankaj Gupta is 1306880992. It was assigned to this individual provider in the NPPES registry on June 15, 2006.

Q: What is Pankaj Gupta's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Pankaj Gupta was last updated on December 13, 2023. 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 June 15, 2006PECOS EnrolledAccepts Medicare Assignment

77.01/100

CMS Quality Rating

4102 N ROXBORO ST, NORTH CAROLINA EYE EAR NOSE AND THROAT, DURHAM, NC 27704(919) 595-2000(919) 595-2190 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Pankaj Gupta Md NPPES

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

PANKAJ GUPTA MD (NPI 1306880992) is an individual otolaryngology provider in Durham, North Carolina, licensed in Wisconsin (41792-020) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Rex Hospital, and is a graduate of Northwestern University Feinberg Medical School (1992).

NPPES Registry Identity

NPI1306880992

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NamePANKAJ GUPTACredential: MD

Location Address4102 N ROXBORO ST, NORTH CAROLINA EYE EAR NOSE AND THROATDurham, NC 27704-2122

Mailing Address4102 N Roxboro St, North Carolina Eye Ear Nose And ThroatDurham, NC 27704-2122 · (919) 595-2000 · Fax (919) 595-2190

Phone(919) 595-2000

Fax(919) 595-2190

Sole ProprietorNo

Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 1992

Enumeration DateJune 15, 2006

Last NPPES UpdateDecember 13, 2023

NPPES CertifiedDecember 13, 2023

✔ NPI 1306880992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in WI · 41792-020

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

4102 N ROXBORO ST, Durham, NC 27704

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Other Identifiers 1

Other2023442NC · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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

Pankaj 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 ID446254239

PECOS Enrollment IDI20090324000490

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 17

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.

Test to assess middle ear function 92567

A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.

151 services141 patients

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.

141 services103 patients

Comprehensive hearing and speech recognition test 92557

A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.

133 services128 patients

Exam of ear using a microscope 92504

An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.

113 services84 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.

92 services65 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.

90 services70 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.

82 services82 patients

Ct scan of face without contrast 70486

A CT scan of the face without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your face, including bones, soft tissues, and blood vessels. It's often used to diagnose diseases, injuries, or abnormalities. No contrast dye is used in this procedure.

73 services62 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

70 services62 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

55 services55 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

39 services33 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

39 services33 patients

Biopsy or removal of nasal polyp or tissue using an endoscope 31237

A nasal biopsy or polyp removal is a procedure where an endoscope, a thin tube with a light and camera, is inserted into the nose. This allows the doctor to see and remove abnormal tissues or polyps, which are small growths. This procedure helps diagnose or treat nasal issues.

26 services18 patients

Ct scan of cranial cavity without contrast 70480

A CT scan of the cranial cavity without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed images of your head, specifically the brain area. This can help detect conditions like tumors, infections, or injuries. No dye (contrast) is used in this procedure.

22 services22 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

22 services22 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

14 services14 patients

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268

This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Rex Hospital

Acute Care Hospitals · Raleigh, NC

5/5 CMS rating

OwnershipGovernment - State

CMS Certification Number340114

Location4420 Lake Boone TrailRaleigh, NC 27607 · Wake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27704 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

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.

77.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

60.39

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use

96%113 patients

Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)

Lower rates are better for this measure.

50%104 patients3/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

29%132 patients2/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

72%3,405 patients3/55-star benchmark: 100%

e-Prescribing

97%509 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%698 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

11%1,909 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

2%2,727 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 0% · 1,058 patients

0%1,058 patients

Provide Patients Electronic Access to Their Health Information

82%692 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

76%219 patients3/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 1% · 725 patients

Patients totalRate: 2% · 725 patients

1%725 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.

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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.

JEREMIAH RICHARD MARION III MD

Ophthalmology