Individual provider Active NPI

Yogendra Upadhyay, MD

  • Psychiatry Physician
  • Amityville, NY
National Provider Identifier
1366430290
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
108074-1 Issued in NY
Practice address
116 Broadway
Amityville, NY 11701-2797
Phone
(516) 908-9768
Fax
(516) 801-4361
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 108074-1 NY
Psychiatry Physician 2084P0800X 108074-1 NY Primary

Addresses

Primary practice location

116 Broadway
Amityville, NY 11701-2797

Mailing address

116 Broadway Ste 6
Amityville, NY 11701-2797
Phone (516) 908-9768

Other practice location 1

400 Montauk Hwy Ste 111
West Islip, NY 11795-4429
Phone (516) 908-9746

Other identifiers 1

IdentifierTypeStateIssuer
00190625MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060406000665 NY Practitioner - PsychiatryPractitioner - Neurology 1153335914 Reassigns benefits to 1 organization
Practice locations: Amityville, NY; West Islip, NY

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 1962
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
108074NYMDSocial Worker
108074-1NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piya Ghoshal MD PC CurrentSince Feb 13, 2022 Accepting new patients
Yogendra Upadhyay MD PC Psychiatry CurrentSince Jan 8, 2024 Accepting new patients
Shahzad Iqbal Physician PLLC PastSince Jun 1, 2020 Accepting new patients
Carnese Associates PastSince Jan 8, 2024 Accepting new patients

Locations

116 Broadway
Ste 6
Amityville, NY 11701
Phone (631) 264-8600

400 Montauk Hwy
Ste 111
West Islip, NY 11795
Phone (631) 587-9009

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1366430290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BROADWAY STE 6",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012797",
            "telephone_number": "516-908-9768",
            "fax_number": "516-801-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012797",
            "telephone_number": "516-908-9768",
            "fax_number": "516-801-4361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Montauk Hwy Ste 111",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954429",
            "country_code": "US",
            "telephone_number": "516-908-9746",
            "fax_number": "516-801-4361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPADHYAY",
        "first_name": "YOGENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "108074-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "108074-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00190625",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.