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DR. VIVEK KUMAR GUPTA M.D.
NPI 1881612133
Otolaryngology in Douglasville, GA

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
6002 PROFESSIONAL PARKWAY, SUITE 100, DOUGLASVILLE, GA 30134(770) 949-4200(770) 949-5553 Get Directions Write a Review

NPPES record last updated: July 14, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Vivek Kumar Gupta M.d. NPPES

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

DR. VIVEK KUMAR GUPTA M.D. (NPI 1881612133) is an individual otolaryngology provider in Douglasville, Georgia, licensed in Georgia (052734) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and is a graduate of Washington University School Of Medicine (1998).

NPPES Registry Identity

NPI1881612133
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. VIVEK KUMAR GUPTACredential: M.D.
Location Address6002 PROFESSIONAL PARKWAY, SUITE 100Douglasville, GA 30134
Mailing Address6002 Professional Parkway, Suite 100Douglasville, GA 30134 · (770) 949-4200 · Fax (770) 949-5553
Phone(770) 949-4200
Fax(770) 949-5553
Sole ProprietorNo
Medical School CMSWashington University School Of MedicineGraduated 1998
Enumeration DateJuly 17, 2006
Last NPPES UpdateJuly 14, 2011
✔ NPI 1881612133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in GA · 052734
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.
6002 PROFESSIONAL PARKWAY, Douglasville, GA 30134
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Other Identifiers 10

Medicare ID-Type Unspecified04BDCMS
Medicaid003379537AGA
Other7157520Aetna Ppo
Other072044Blue
Medicaid003379537BGA
Medicare UPINH95242
Other5418507001Cigna
OtherP00107542Railroad Medicare
Other323384Wellcare
Other7157520Aetna Hmo

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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. Vivek Kumar Gupta M.d. 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 ID2961422381
PECOS Enrollment IDI20051130000713
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 9

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 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.
298 services220 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.
108 services108 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.
67 services63 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.
56 services56 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.
46 services46 patients
Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope 42975
This procedure examines your upper airway for sleep-related breathing issues. An endoscope, a thin tube with a light and camera, is gently inserted through your nose. This allows a detailed view of your airway to identify any abnormalities that could disrupt your sleep.
17 services17 patients

Hospital Affiliations CMS Care Compare 4

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110035
Location677 Church StreetMarietta, GA 30060 · Cobb County
Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110042
Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30134 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 13

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
6 suppliers42 claims42 services$32.41 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers34 claims34 services$67.88 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers34 claims96 services$24.87 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers19 claims106 services$15.28 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
5 suppliers18 claims104 services$13.81 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
8 suppliers38 claims38 services$49.56 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC
Surgery
6002 PROFESSIONAL PARKWAY, SUITE 260
DOUGLASVILLE, GA 30134
Douglas County (770) 942-4822
GEORGIA CANCER SPECIALISTS I PC
Internal Medicine (Hematology & Oncology)
6002 PROFESSIONAL PARKWAY, SUITE 200
DOUGLASVILLE, GA 30134
Douglas County (770) 942-0457
BI-COUNTY ENT, LLC
Otolaryngology
6002 PROFESSIONAL PARKWAY, SUITE 100
DOUGLASVILLE, GA 30134
Douglas County (770) 949-4200

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 Vivek Gupta's NPI number?

The NPI number for Vivek Gupta is 1881612133. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Vivek Gupta located?

Vivek Gupta practices at 6002 Professional Parkway Suite 100, Douglasville, GA 30134. The listed phone number is (770) 949-4200.

What is Vivek Gupta's specialty?

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

Is Vivek Gupta enrolled in Medicare?

Yes. Vivek 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 Vivek Gupta accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Vivek 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 Vivek Gupta affiliated with any hospitals?

According to CMS data, Vivek Gupta is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Paulding Medical Center, Wellstar Cobb Medical Center and Wellstar Douglas Medical Center.

When was this NPI record last updated?

The NPPES record for Vivek Gupta was last updated on July 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.