Individual provider Active NPI

Ajay Kumar Upadhyay, MD

  • Surgery Physician
  • Oakland, CA
National Provider Identifier
1104888155
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A53488 Issued in CA
Practice address
365 Hawthorne Ave
Ste 101
Oakland, CA 94609-3115
Phone
(510) 465-5523
Fax
(510) 832-6061
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A53488 CA Primary

Addresses

Primary practice location

365 Hawthorne Ave
Ste 101
Oakland, CA 94609-3115

Mailing address

365 Hawthorne Ave
Ste 101
Oakland, CA 94609-3115
Phone (510) 465-5523

Other practice location 1

3010 Colby St Ste 118
Berkeley, CA 94705-2059
Phone (510) 486-0818

Other practice location 2

27206 Calaroga Ave Ste 206
Hayward, CA 94545-4300
Phone (510) 732-5731

Other identifiers 1

IdentifierTypeStateIssuer
GR0098240MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000545 CA Practitioner - General Surgery 0244364529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

350 30TH St
Suite 320
Oakland, CA 94609-3425
Phone (510) 204-1844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)27
Upper gastrointestinal (GI) endoscopy for acid reflux21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A53488CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Bay Area Surgical Specialists, Inc a Medical Corporation CurrentSince Apr 1, 2021 Accepting new patients
Bass Medical Group Current Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Bass Medical Group Specialist Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
Madison Medical Center Stockhoff Memorial Nursing Home Past Accepting new patients
HCA Healthone LLC Past Accepting new patients
Parkland Health Center Past Accepting new patients
Alameda Health System Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

4721 Dallas Ranch Rd
Antioch, CA 94531
Phone (925) 676-2600

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

3010 Colby St
Ste 118
Berkeley, CA 94705
Phone (510) 486-0818

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

27206 Calaroga Ave
Ste 208
Hayward, CA 94545
Phone (510) 264-0300

27206 Calaroga Ave
Ste 206
Hayward, CA 94545
Phone (510) 732-5731

365 Hawthorne Ave
Ste 101
Oakland, CA 94609
Phone (510) 465-5523

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

350 30th St
Ste 320
Oakland, CA 94609
Phone (510) 465-6700

365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424

355 Lennon Ln
Ste 205
Walnut Creek, CA 94598
Phone (925) 935-0627

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: aupadhyay161300@hisp.ehr.sutterhealth.org
  • FHIR API: https://pmh-vmhaiku-01.pmh.org/FHIR/PARKLAND/api/FHIR/R4
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: aupadhyay111903@ehr.johnmuirhealth.com
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1104888155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "STE 101",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093115",
            "telephone_number": "510-465-5523",
            "fax_number": "510-832-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "STE 101",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093115",
            "telephone_number": "510-465-5523",
            "fax_number": "510-832-6061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3010 Colby St Ste 118",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052059",
            "country_code": "US",
            "telephone_number": "510-486-0818",
            "fax_number": "510-486-0819",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27206 Calaroga Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945454300",
            "country_code": "US",
            "telephone_number": "510-732-5731",
            "fax_number": "510-732-5739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPADHYAY",
        "first_name": "AJAY",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A53488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.