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AJAY GUPTA MD
NPI 1598052318
Internal Medicine in Albemarle, NC

Active since June 30, 2011PECOS EnrolledAccepts Medicare Assignment
95.35/100
CMS Quality Rating
301 YADKIN ST, ALBEMARLE, NC 28001(704) 984-4365 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 15, 2024, Aug 23, 2023, May 4, 2023 and 49 more (52 updates tracked since 2018).

About Ajay Gupta Md NPPES

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

AJAY GUPTA MD (NPI 1598052318) is an individual internal medicine provider in Albemarle, North Carolina, licensed in North Carolina (2014-02045) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center/behav Health, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1598052318
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameAJAY GUPTACredential: MD
Location Address301 YADKIN STAlbemarle, NC 28001-3441
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Phone(704) 984-4365
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateJune 30, 2011
Last NPPES UpdateJuly 15, 202452 updates tracked since enumeration
NPPES CertifiedAugust 23, 2023
✔ NPI 1598052318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 2014-02045
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License 2014-02045 (NC)
301 YADKIN ST, Albemarle, NC 28001
Open in Google Maps ↗

Secondary Practice Locations 4

Location 12001 Vail AveCharlotte, NC 28207-1248 · Phone (704) 304-6070
Location 28800 N Tryon StCharlotte, NC 28262-3300 · Phone (704) 863-6241
Location 31000 Blythe BlvdCharlotte, NC 28203-5812 · Phone (704) 355-0720
Location 410628 Park RdCharlotte, NC 28210-8407 · Phone (704) 667-7070

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc.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

Ajay 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 ID2769638477
PECOS Enrollment IDI20151103003128
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
179 services88 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.
120 services58 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
60 services58 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.
55 services54 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
44 services19 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
27 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340113
Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County
Emergency services Birthing friendly

Atrium Health University City

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340166
Location8800 North Tyron StreetCharlotte, NC 28262 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28001 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
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

95.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.22
Promoting Interoperability100
Improvement Activities40

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.

MR. LARRY NMI ROEDIGER PA-C
Physician Assistant
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (704) 984-4382
LAUREN HINSON HUNEYCUTT PHARMD
Pharmacist
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (980) 323-4500
STANLY REGIONAL MEDICAL CENTER
General Acute Care Hospital
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (704) 984-4000
STEPHEN REBER PA-C
Physician Assistant
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (980) 323-4000
CHRIS R BRYAN PT
Physical Therapist
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (704) 984-4290
MRS. ANJANA MENON YOUNG CRNA
Nurse Anesthetist, Certified Registered
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (980) 323-4590
STACEY EVELYN FURR FNP
Nurse Practitioner (Family)
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (704) 984-4365
PAUL A D'AMICO D.O.
Emergency Medicine
301 YADKIN ST
ALBEMARLE, NC 28001
Stanly County (704) 984-4160

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 Ajay Gupta's NPI number?

The NPI number for Ajay Gupta is 1598052318. It was assigned to this individual provider in the NPPES registry on June 30, 2011.

Where is Ajay Gupta located?

Ajay Gupta practices at 301 Yadkin St, Albemarle, NC 28001. The listed phone number is (704) 984-4365.

What is Ajay Gupta's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ajay Gupta enrolled in Medicare?

Yes. Ajay 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 Ajay Gupta accept?

Health plans from Blue Cross and Blue Shield of NC and Oscar Health Plan of North Carolina, Inc list Ajay 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 Ajay Gupta affiliated with any hospitals?

According to CMS data, Ajay Gupta is affiliated with Carolinas Medical Center/Behav Health and Atrium Health University City.

When was this NPI record last updated?

The NPPES record for Ajay Gupta was last updated on July 15, 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.