Organization Active NPI

Yogendra Upadhyay MD PC

  • Psychiatry Physician
  • West Islip, NY
National Provider Identifier
1265294979
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
YOGENDRA UPADHYAY MD PC
Practice address
400 Montauk Hwy Ste 109
West Islip, NY 11795-4429
Phone
(516) 480-5578
Fax
(516) 801-4361
NPI assigned
Jan 29, 2024
Last updated
Jan 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Yogendra Upadhyay, MDNPI 1366430290
Title
President
Phone
(516) 480-5578

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
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

400 Montauk Hwy Ste 109
West Islip, NY 11795-4429

Mailing address

400 Montauk Hwy Ste 109
West Islip, NY 11795-4429
Phone (516) 480-5578

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240305001298 NY Part B Supplier - Clinic/Group Practice 5890130413 Receives reassigned benefits from 1 practitioner
Practice locations: West Islip, NY

National Provider Directory

National Provider Directory

Locations

400 Montauk Hwy
Ste 109
West Islip, NY 11795
Phone (516) 480-5578

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1265294979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY STE 109",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "516-480-5578",
            "fax_number": "516-801-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY STE 109",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "516-480-5578",
            "fax_number": "516-801-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOGENDRA UPADHYAY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-27",
        "status": "A",
        "authorized_official_last_name": "UPADHYAY",
        "authorized_official_first_name": "YOGENDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-480-5578",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.