Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NISHA GUPTA M.D.
NPI 1790072726
Hospitalist in Rochester, NY

Active since June 28, 2011PECOS Enrolled
95.19/100
CMS Quality Rating
1425 PORTLAND AVE, ROCHESTER, NY 14621(585) 922-5067(585) 922-2908 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 4, 2022, May 4, 2021, Apr 15, 2021 and 1 more (4 updates tracked since 2020).

About Nisha Gupta M.d. NPPES

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

NISHA GUPTA M.D. (NPI 1790072726) is an individual hospitalist provider in Rochester, New York, licensed in Florida (ME168501) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790072726
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameNISHA GUPTACredential: M.D.
Location Address1425 PORTLAND AVERochester, NY 14621-3001
Mailing Address100 Kings Hwy SRochester, NY 14617-5504 · (585) 922-5067 · Fax (585) 922-2908
Fax(585) 922-2908
Sole ProprietorNo
Enumeration DateJune 28, 2011
Last NPPES UpdateOctober 23, 20264 updates tracked since enumeration
NPPES CertifiedOctober 23, 2026
✔ NPI 1790072726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in FL · ME168501
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License ME168501 (FL)
1425 PORTLAND AVE, Rochester, NY 14621

Other Identifiers 2

Medicaid03007072/RGHNY
Medicaid01131126/RGHNY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nisha Gupta M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Nisha Gupta reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

General Acute Care Hospital
1425 PORTLAND AVE
Rochester, NY 14621
  • Reassigned Medicare billing, New York enrollment
  • 2,285 clinicians in this Medicare group
Family Medicine
1425 PORTLAND AVE
Rochester, NY 14621
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Western New York Medical Practice PC
  • 1,030 clinicians in this Medicare group
General Acute Care Hospital
100 KINGS HWY S
Rochester, NY 14617
  • Reassigned Medicare billing, New York enrollment
  • 1,442 clinicians in this Medicare group
General Acute Care Hospital
1200 DRIVING PARK AVE
Newark, NY 14513
  • Reassigned Medicare billing, New York enrollment
  • 679 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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 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.
89 services30 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.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14621 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

95.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality70.62
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.

Dentist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Anesthesiology
1425 PORTLAND AVE
ROCHESTER, NY 14621
Physician Assistant
1425 PORTLAND AVE, BOX 362
ROCHESTER, NY 14621
Emergency Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Emergency Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Internal Medicine (Hematology)
1425 PORTLAND AVE
ROCHESTER, NY 14621
Hospitalist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Hospitalist
1425 PORTLAND AVE
ROCHESTER, NY 14621

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 Nisha Gupta's NPI number?

The NPI number for Nisha Gupta is 1790072726. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Where is Nisha Gupta located?

Nisha Gupta practices at 1425 Portland Ave, Rochester, NY 14621. The listed phone number is (585) 922-5067.

What is Nisha Gupta's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Nisha Gupta enrolled in Medicare?

Yes. Nisha Gupta is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nisha Gupta's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nisha Gupta reassigns Medicare benefits to 4 organizations: Rochester General Hospital (Rochester, NY), Western New York Medical Practice P.C. (Rochester, NY), The Unity Hospital Of Rochester (Rochester, NY) and Newark Wayne Community Hospital (Newark, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nisha Gupta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nisha Gupta was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days 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.