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PAWAN K GUPTA MD
NPI 1649287012
Internal Medicine - Nephrology in Altoona, PA

Active since August 01, 2006PECOS EnrolledAccepts Medicare Assignment
91.48/100
CMS Quality Rating
122 E CHESTNUT AVE, ALTOONA, PA 16601(814) 943-3600(814) 943-3675 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, May 15, 2017 (2 updates tracked since 2017).

About Pawan K Gupta Md NPPES

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

PAWAN K GUPTA MD (NPI 1649287012) is an individual nephrology provider in Altoona, Pennsylvania, licensed in Pennsylvania (MD066182L) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Huntingdon, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1649287012
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NamePAWAN K GUPTACredential: MD
Location Address122 E CHESTNUT AVEAltoona, PA 16601-5202
Mailing Address122 E Chestnut AveAltoona, PA 16601 · (814) 943-3600 · Fax (814) 943-3675
Phone(814) 943-3600
Fax(814) 943-3675
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateAugust 1, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1649287012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in PA · MD066182L
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
122 E CHESTNUT AVE, Altoona, PA 16601
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Pawan K 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 ID4880612803
PECOS Enrollment IDI20060322000604
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 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.
138 services72 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
101 services15 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
71 services71 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.
62 services53 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.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Penn Highlands Huntingdon

Acute Care Hospitals · Huntingdon, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390056
Location1225 Warm Springs AveHuntingdon, PA 16652 · Huntingdon County
Emergency services

Upmc Altoona

Acute Care Hospitals · Altoona, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390073
Location620 Howard AvenueAltoona, PA 16601 · Blair County
Emergency services Birthing friendly

Penn Highlands Tyrone

Critical Access Hospitals · Tyrone, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number391307
Location187 Hospital DriveTyrone, PA 16686 · Blair County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16601 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

91.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40
Cost49.64

Other Providers at the Same Location NPPES

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

ANJU GUPTA M.D.
Internal Medicine
122 E CHESTNUT AVE
ALTOONA, PA 16601
Blair County (814) 943-3600

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 Pawan Gupta's NPI number?

The NPI number for Pawan Gupta is 1649287012. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Pawan Gupta located?

Pawan Gupta practices at 122 E Chestnut Ave, Altoona, PA 16601. The listed phone number is (814) 943-3600.

What is Pawan Gupta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Pawan Gupta enrolled in Medicare?

Yes. Pawan 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 Pawan Gupta accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Pawan 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 Pawan Gupta affiliated with any hospitals?

According to CMS data, Pawan Gupta is affiliated with Penn Highlands Huntingdon, Upmc Altoona and Penn Highlands Tyrone.

When was this NPI record last updated?

The NPPES record for Pawan Gupta was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.