KANAV GUPTA – Internal Medicine Physician, NPI 1174263149

KANAV GUPTA is a healthcare provider. based in Worcester, Massachusetts. specializing in INTERNAL MEDICINE. They hold a License No. 1023889 (MA). The NPI Number for KANAV GUPTA is 1174263149

Main info

Male
4 Years Of Experience
Name
KANAV GUPTA
NPI
1174263149
Phone
(508) 334-1000
Address
55 LAKE AVE N
Enumeration Date
29 March 2022
Last Update Date
3 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5088607800
Graduation Year
2022 (4 years ago)
PAC ID
5597141358
Group Practice PAC ID
4789670985
Professional Enrollment ID
I20250616001872
Address ID
MA016102473WO26XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

7,722 INTERNAL MEDICINE in MA

Provider Addresses for KANAV GUPTA

  • 55 LAKE AVE N

    WORCESTER, MA 016550002

    Phone: (508) 334-1000

    Type: Mailing

  • 26 QUEEN ST

    WORCESTER, MA 01610

    Phone: (508) 860-7700

    Fax: (508) 860-7875

    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: 2025-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250616001872IInternal MedicineMATBD

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.

Verify on CMS Revalidation Lookup Tool

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 01655)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789670985View full group profile
NameSpecialtyState
Nurse PractitionerMA
-MA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Family PracticeMA
Clinical Social WorkerMA
Nurse PractitionerMA
Nurse PractitionerMA
Family PracticeMA

Reviews

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Frequently asked questions

Can I verify KANAV GUPTA with an NPI only?
You can start verification with NPI 1174263149 for KANAV GUPTA, then check state licensing separately.
Can I rely on KANAV GUPTA being an active provider?
As of the registry snapshot, KANAV GUPTA is marked active.
What is KANAV GUPTA's primary classification?
Internal Medicine Physician is the headline specialty for KANAV GUPTA here. Clinical services aligned with this taxonomy classification.
Where is KANAV GUPTA based?
KANAV GUPTA is tied to Worcester, Massachusetts in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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