Individual provider Active NPI

Shivanck Upadhyay, MBBS, MD

  • Pulmonary Disease Physician
  • Paterson, NJ
National Provider Identifier
1376815647
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA10446900 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-2000
Fax
(973) 754-3376
NPI assigned
Feb 2, 2012
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA10446900 NJ
Pulmonary Disease Physician 207RP1001X 0101284367 VA
Pulmonary Disease Physician 207RP1001X 84972 WI
Pulmonary Disease Physician 207RP1001X 25MA10446900 NJ Primary
Internal Medicine Physician 207R00000X 84972 WI
Pulmonary Disease Physician 207RP1001X 61005 KY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA10446900 NJ

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

703 Main St
Medicine Department
Paterson, NJ 07503-2621

Other practice location 1

130 2nd St
Neenah, WI 54956-2883
Phone (920) 731-4101

Other practice location 2

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-4101

Other practice location 3

1 Medical Village Drive
Edgewood, KY 41017-3403
Phone (859) 757-2927

Other practice location 4

618 Hospital Rd
Tappahannock, VA 22560-5000
Phone (804) 828-4635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, WI, VA, KY5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20141030000804 NY Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6002037371 Reassigns benefits to 3 organizations
I20190131000075 NJ Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6002037371 Reassigns benefits to 2 organizations
I20250128004100 WI Practitioner - Pulmonary Disease 6002037371 Reassigns benefits to 11 organizations
I20250410001404 VA Practitioner - Pulmonary Disease 6002037371 Reassigns benefits to 1 organization
I20250731000296 KY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6002037371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

1414 N Taylor Dr
Sheboygan, WI 53081-1988
Phone (920) 320-2436

2300 Western Ave
Manitowoc, WI 54220-3712
Phone (920) 320-2011

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10446900NJMDInternal Medicine Physician
61005KYMDPulmonary Disease Physician
0101284367VAMDPulmonary Disease Physician
84972WIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc. CurrentSince Feb 4, 2025 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Feb 4, 2025 Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince Feb 4, 2025 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Feb 4, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Feb 4, 2025 Accepting new patients
The Howard Young Medical Center, Inc. Current Accepting new patients
St Josephs Medical Group PC Internal Medicine CurrentSince Nov 2, 2021 Accepting new patients
Critical Care Physician of New York PC Critical Care Medicine CurrentSince Aug 1, 2017 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. Current Accepting new patients
Thedacare, Incorporated CurrentSince Jan 1, 2025 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Feb 4, 2025 Accepting new patients
Froedtert Manitowoc Medical Group, LLC Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
St. Joseph's Healthcare, Inc. Internal Medicine CurrentSince Dec 17, 2018 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Mar 1, 2025 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc CurrentSince Feb 4, 2025 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Feb 4, 2025 Accepting new patients
Aspirus Eagle River Hospital, Inc. CurrentSince Feb 4, 2025 Accepting new patients
MCV Associated Physicians CurrentSince Apr 5, 2025 Accepting new patients
Summit Medical Group, Inc Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations (25 of 33)

29980 Network Pl
Chicago, IL 60673

124 SW Adams St
Fl 2
Peoria, IL 61602
Phone (309) 655-2850

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

70 Dubois St
Fl 2
Newburgh, NY 12550
Phone (845) 561-4400

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

618 Hospital Rd
Tappahannock, VA 22560
Phone (804) 443-3311

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-3000

Interoperability endpoints

  • Direct secure messaging: supadhyay668832@direct.saint-lukes.org
  • Direct secure messaging: supadhyay854644@direct.froedtert.com

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 1

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": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1376815647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "address_2": "MEDICINE DEPARTMENT",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000",
            "fax_number": "973-754-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 2nd St",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549562883",
            "country_code": "US",
            "telephone_number": "920-731-4101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-731-4101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Village Drive",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-757-2927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Tappahannock",
            "state": "VA",
            "postal_code": "225605000",
            "country_code": "US",
            "telephone_number": "804-828-4635",
            "fax_number": "804-443-6150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPADHYAY",
        "first_name": "SHIVANCK",
        "name_prefix": "Dr.",
        "credential": "MBBS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-02",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10446900",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101284367",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "84972",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA10446900",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "84972",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "61005",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA10446900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.