Organization Active NPI

Manish Upadhyay, MD, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Roseville, CA
National Provider Identifier
1104186691
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
C52329 Issued in CA
Legal business name
MANISH UPADHYAY, MD, INC
Practice address
508 Gibson Dr
Suite No 270
Roseville, CA 95678-5794
Phone
(916) 786-6727
Fax
(916) 786-6748
NPI assigned
May 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Dr. Manish Upadhyay, MDNPI 1962432039
Title
President
Phone
(916) 786-6727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X C52329 CA Primary

Addresses

Primary practice location

508 Gibson Dr
Suite No 270
Roseville, CA 95678-5794

Mailing address

508 Gibson Dr
Suite No 270
Roseville, CA 95678-5794
Phone (916) 786-6727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120820000231 CA Part B Supplier - Clinic/Group Practice 2668628033 Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2038113Manish Upadhyay, MD Inc508 Gibson Dr Ste 270, Roseville, CA 95678Certificate of waiverMar 12, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1104186691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 GIBSON DR",
            "address_2": "SUITE NO 270",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785794",
            "telephone_number": "916-786-6727",
            "fax_number": "916-786-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 GIBSON DR",
            "address_2": "SUITE NO 270",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785794",
            "telephone_number": "916-786-6727",
            "fax_number": "916-786-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANISH UPADHYAY, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "UPADHYAY",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-786-6727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "C52329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.