Individual ProviderMohinder GuptaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4500 Parsons Blvd, Department Of Medicine, Flushing, NY 11355(718) 670-5486(718) 206-6984PECOS EnrollmentBased on the most recent information from CMS, provider Mohinder Gupta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1659337285Provider TypeIndividualFull NameGupta, MohinderCredentialMDGenderMaleSole ProprietorYesEnumeration Date4/22/2006Last Updated3/27/2013Contact InformationPractice LocationPractice Address4500 Parsons Blvd, Department Of Medicine, Flushing, NY 11355Phone(718) 670-5486Fax(718) 670-8988Mailing LocationMailing Address89-06 135th St, Jamaica, NY 11418Phone(718) 206-6984Fax(718) 206-6786Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense108186New YorkCode207RC0000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense108186New YorkProvider IdentifiersIDDescriptionIssuerID00190978DescriptionMedicaidIssuerUnlistedNew York