DR. SAHIL GUPTA MD
NPI 1932712593
Family Medicine in Sheboygan, WI

Q: What is Sahil Gupta's NPI number?

The NPI number for Sahil Gupta is 1932712593. It was assigned to this individual provider in the NPPES registry on August 24, 2020.

Q: What is Sahil Gupta's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sahil Gupta was last updated on January 18, 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.

Active since August 24, 2020PECOS EnrolledAccepts Medicare Assignment

1411 N TAYLOR DR, SHEBOYGAN, WI 53081(920) 496-4700 Get Directions Write a Review

NPPES record last updated: January 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Sahil Gupta Md NPPES

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

DR. SAHIL GUPTA MD (NPI 1932712593) is an individual family medicine provider in Sheboygan, Wisconsin, licensed in Wisconsin (82350-20) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS, is affiliated with St Nicholas Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1932712593

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SAHIL GUPTACredential: MD

Location Address1411 N TAYLOR DRSheboygan, WI 53081-3043

Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700

Phone(920) 496-4700

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 24, 2020

Last NPPES UpdateJanuary 18, 2024

NPPES CertifiedJanuary 18, 2024

✔ NPI 1932712593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WI · 82350-20✔ Licensed in NH · RT-3657

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1411 N TAYLOR DR, Sheboygan, WI 53081

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Other Identifiers 1

Medicaid100252282WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Security Health Plan.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. Sahil 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 ID6507285020

PECOS Enrollment IDI20231013001412

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

80 services42 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 services34 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.

38 services29 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.

17 services17 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.

17 services15 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520044

Location3100 Superior AveSheboygan, WI 53081 · Sheboygan County

Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520075

Location835 S Van Buren StGreen Bay, WI 54301 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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

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

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

2 suppliers11 claims480 services$0.09 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 20

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

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