NPIMap

Individual provider Active NPI

Brian Upper, P.A.

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1073867172
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006451 Issued in MI
Practice address
1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806
Phone
(517) 364-9650
Fax
(517) 364-9605
NPI assigned
Oct 29, 2012
Last updated
Oct 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006451 MI Primary

Addresses

Primary practice location

1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806

Mailing address

405 W Greenlawn Ave
Lansing, MI 48910-2898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130204000227 MI Practitioner - Physician Assistant 9032363874 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sparrow Carson HospitalGroup PAC ID 7113836701, 63 clinicians

Practice addresses (Care Compare)

1140 E Michigan Ave
Lansing, MI 48912-1806

245 S 2ND St
Carson City, MI 48811-9650

401 E Elm St
Carson City, MI 48811-9693
Phone (989) 584-6217

406 E Elm St
Carson City, MI 48811-9693

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006451MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Feb 1, 2025 Accepting new patients
Sparrow Carson Hospital CurrentSince Nov 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association Physician Assistant CurrentSince Feb 9, 2015 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Feb 9, 2015 Accepting new patients
Sparrow Carson Hospital CurrentSince Nov 1, 2024 Accepting new patients
Sparrow Ionia Hospital CurrentSince Feb 1, 2025 Accepting new patients
Sparrow Carson Hospital Past Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1498

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1140 E Michigan Ave
Ste 400
Lansing, MI 48912
Phone (517) 483-7550

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

300 Health Park Dr
Ste 301
Owosso, MI 48867
Phone (989) 723-3613

901 S Oakland St
Ste 101
Saint Johns, MI 48879
Phone (517) 332-4263

301 Williamston Center Rd
Williamston, MI 48895
Phone (517) 253-5125

Interoperability endpoints

  • Direct secure messaging: bupper28966@sparrowdirecthie.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1073867172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E MICHIGAN AVE STE 400",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121806",
            "telephone_number": "517-364-9650",
            "fax_number": "517-364-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPPER",
        "first_name": "BRIAN",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-29",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.