MANIK KUMAR GUPTA – General Practice Physician, NPI 1548655681
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,340 ANESTHESIOLOGY in FL
Provider Addresses for MANIK KUMAR GUPTA
313 BROADMOOR WAY
MCDONOUGH, GA 302534290
Phone: (404) 805-3042
Type: Mailing
1611 NW 12TH AVE
MIAMI, FL 331361005
Phone: (313) 745-8778
Type: Location
2601 E ROOSEVELT ST
PHOENIX, AZ 850084973
Phone: (602) 344-5011
Type: Location
400 W 16th St
Pueblo, CO 810032745
Phone: (719) 584-4045
Fax: (719) 542-0809
Type: Location
4201 Saint Antoine St
Detroit, MI 48201
Phone: (404) 805-3042
Type: Location
3800 WOODWARD AVE APT 704
DETROIT, MI 482011980
Phone: (404) 805-3042
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200713001721 | I | Anesthesiology | MI | TBD |
| I20210722001891 | I | Anesthesiology | AZ | TBD |
| I20251231001225 | I | Anesthesiology | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30253)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Critical Care (Intensivists) | IL | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Vascular Surgery | IL | |
| - | MI | |
| - | MI | |
| A N E S T H E S I O L O G Y | TX | |
| Clinical Social Worker | MI |
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