Shivanck Upadhyay, MBBS, MD
NPI 1376815647 · Pulmonary Disease Physician · Paterson, NJ
Enrolled with Medicare as Practitioner - Pulmonary Disease · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shivanck Upadhyay, MBBS, MD is a Pulmonary Disease Physician provider in Paterson, NJ (NPI 1376815647).
Provider details
- NPI number
- 1376815647
- Entity type
- Individual
- Primary specialty
- Pulmonary Disease PhysicianAllopathic & Osteopathic Physicians
- Credential
- MBBS, MD
- Sex
- Male
- Sole proprietor
- No
- License
- 25MA10446900 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
14 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
5 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
359 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Critical Care, First 30-74 Minutes99291 | 158 | $212 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 50 Minutes99233 | 68 | $115 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 35 Minutes99232 | 48 | $76 |
| Critical Care, Each Additional 30 Minutes99292 | 45 | $107 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 40 | $174 |
Typical Medicare-allowed amounts for these services range $76–$212 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$13 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (4)
- 1 Medical Village DriveEdgewood, KY 41017-3403Phone: (859) 757-2927
- 618 Hospital RdTappahannock, VA 22560-5000Phone: (804) 828-4635Fax: (804) 443-6150
- 1818 N Meade StAppleton, WI 54911-3454Phone: (920) 731-4101
- 130 2nd StNeenah, WI 54956-2883Phone: (920) 731-4101
Registry dates
- Enumerated
- 2012-02-02
- Last updated
- 2026-04-27
- Certified
- 2026-04-27
Frequently asked questions
- What is Shivanck Upadhyay's NPI number?
- Shivanck Upadhyay's National Provider Identifier (NPI) is 1376815647, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shivanck Upadhyay's specialty?
- Shivanck Upadhyay is listed in the NPPES registry with a primary specialty of Pulmonary Disease Physician (Allopathic & Osteopathic Physicians).
- Where is Shivanck Upadhyay located?
- Shivanck Upadhyay's practice location on file with NPPES is 703 Main St, Paterson, NJ 07503-2621.
- What is Shivanck Upadhyay's phone number?
- The practice phone number listed in the NPPES registry for Shivanck Upadhyay is (973) 754-2000.
- Does Shivanck Upadhyay accept Medicare?
- Shivanck Upadhyay is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shivanck Upadhyay's NPI active?
- Yes — Shivanck Upadhyay's NPI (1376815647) is active in the NPPES registry as of the last update on 2026-04-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.