Individual provider Active NPI

Shashank Upadhyay, D.O.

  • Emergency Medicine Physician
  • Rockville, MD
National Provider Identifier
1396162558
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
H0083207 Issued in MD
Practice address
9901 Medical Center Dr
Rockville, MD 20850-3357
Phone
(240) 826-6000
NPI assigned
Mar 26, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X H0083207 MD Primary

Addresses

Primary practice location

9901 Medical Center Dr
Rockville, MD 20850-3357

Mailing address

2399 Bellarosa Cir
West Palm Beach, FL 33411-1473
Phone (561) 310-0814

Other practice location 1

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 545-7345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20170816002916 DC Practitioner - Emergency Medicine 6901178599 Reassigns benefits to 2 organizations
I20200420003273 MD Practitioner - Emergency Medicine 6901178599 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0083207MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Maryland, LLC Single Specialty CurrentSince Apr 4, 2020 Accepting new patients
Mep Health, LLC Single Specialty CurrentSince Jul 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

Organizations & group practices 3

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396162558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 BELLAROSA CIR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334111473",
            "telephone_number": "561-310-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503357",
            "telephone_number": "240-826-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-545-7345",
            "fax_number": "915-545-7338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPADHYAY",
        "first_name": "SHASHANK",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "H0083207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.