DR. PRAG GUPTA MD
NPI 1801879911
Internal Medicine - Pulmonary Disease in Denver, NC

Q: What is Prag Gupta's NPI number?

The NPI number for Prag Gupta is 1801879911. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Q: What is Prag Gupta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Prag Gupta was last updated on January 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 November 22, 2005PECOS EnrolledAccepts Medicare Assignment

1585 FORNEY CREEK PKWY STE 2200, DENVER, NC 28037(704) 951-8444(704) 360-9978 Get Directions Write a Review

NPPES record last updated: January 31, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 31, 2019, Sep 21, 2018, May 17, 2018 and 1 more (4 updates tracked since 2017).

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About Dr. Prag Gupta Md NPPES

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

DR. PRAG GUPTA MD (NPI 1801879911) is an individual pulmonary disease provider in Denver, North Carolina, licensed in North Carolina (200401220) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center/behav Health, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1801879911

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. PRAG GUPTACredential: MD

Location Address1585 FORNEY CREEK PKWY STE 2200Denver, NC 28037-9522

Mailing AddressPo Box 3246Mooresville, NC 28117-3246 · (704) 951-8444 · Fax (704) 360-9978

Phone(704) 951-8444

Fax(704) 360-9978

Sole ProprietorYes

Medical School CMSOtherGraduated 1999

Enumeration DateNovember 22, 2005

Last NPPES UpdateJanuary 31, 20194 updates tracked since enumeration

✔ NPI 1801879911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in NC · 200401220

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 200401220 (NC)

1585 FORNEY CREEK PKWY STE 2200, Denver, NC 28037

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Blue Cross and Blue Shield of NC 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

Dr. Prag 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 ID1456311380

PECOS Enrollment IDI20091117000554, I20170926001150

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 18

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.

781 services334 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

462 services322 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

314 services285 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

284 services274 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.

247 services185 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

241 services234 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.

188 services184 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.

143 services143 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

104 services37 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

103 services101 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.

94 services94 patients

Test to measure the level of nitric oxide gas 95012

A test to measure the level of nitric oxide gas helps assess inflammation in the lungs, often linked with asthma. You'll breathe into a device, and it'll provide a reading of nitric oxide levels. This helps monitor and manage respiratory conditions.

92 services78 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

68 services43 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

59 services12 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.

33 services31 patients

Evaluation of use of breathing device 94664

The evaluation of a breathing device involves checking how effectively you're using it to manage your respiratory condition. It assesses the device's fit, your comfort, and your technique to ensure optimal results.

32 services32 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

26 services18 patients

Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296

This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.

21 services21 patients

Hospital Affiliations CMS Care Compare 5

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 Lincoln

Acute Care Hospitals · Lincolnton, NC

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340145

Location433 Mcalister RdLincolnton, NC 28092 · Lincoln County

Emergency services Birthing friendly

Novant Health Ballantyne Medical Center

Acute Care Hospitals · Charlotte, NC

OwnershipVoluntary non-profit - Private

CMS Certification Number340195

Location10905 Providence Road WCharlotte, NC 28277 · Mecklenburg County

Emergency services Birthing friendly

Piedmont Medical Center

Acute Care Hospitals · Rock Hill, SC

2/5 CMS rating

OwnershipProprietary

CMS Certification Number420002

Location1731 Frank Gaston BlvdRock Hill, SC 29732 · York County

Emergency services Birthing friendly

Musc Health Lancaster Medical Center

Acute Care Hospitals · Lancaster, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420036

Location800 W Meeting StLancaster, SC 29720 · Lancaster County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28037 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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers17 claims19 services$23.33 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

7 suppliers120 claims121 services$72.07 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers79 claims79 services$30.46 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

3 suppliers15 claims1,110 services$0.85 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

2 suppliers14 claims14 services$26.21 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

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

TRI-COUNTY PULMONARY AND CRITICAL CARE PLLC

Internal Medicine (Pulmonary Disease)

1585 FORNEY CREEK PKWY STE 2200
DENVER, NC 28037

Lincoln County (704) 951-8444

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 Prag Gupta's NPI number?

The NPI number for Prag Gupta is 1801879911. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Where is Prag Gupta located?

Prag Gupta practices at 1585 Forney Creek Pkwy Ste 2200, Denver, NC 28037. The listed phone number is (704) 951-8444.

What is Prag Gupta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Prag Gupta enrolled in Medicare?

Yes. Prag 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 Prag Gupta accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Blue Cross and Blue Shield of NC, BlueCross BlueShield of South Carolina and Molina Healthcare list Prag 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 Prag Gupta affiliated with any hospitals?

According to CMS data, Prag Gupta is affiliated with Carolinas Medical Center/Behav Health, Atrium Health Lincoln, Novant Health Ballantyne Medical Center, Piedmont Medical Center and Musc Health Lancaster Medical Center.

When was this NPI record last updated?

The NPPES record for Prag Gupta was last updated on January 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.