Individual provider Active NPI

Amit Upadhiaya, DO

  • Internal Medicine Physician
  • Pompano Beach, FL
National Provider Identifier
1417938499
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS9136 Issued in FL
Practice address
1 W Sample Rd
#201
Pompano Beach, FL 33064-3547
Phone
(954) 782-3170
Fax
(954) 782-3171
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS9136 FL Primary

Addresses

Primary practice location

1 W Sample Rd
#201
Pompano Beach, FL 33064-3547

Mailing address

1 W Sample Rd
#201
Pompano Beach, FL 33064-3547
Phone (954) 782-3170

Other identifiers 1

IdentifierTypeStateIssuer
270704700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040811000450 FL Practitioner - Internal Medicine 1153393053 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medicine Services, LLCGroup PAC ID 7810129640, 263 clinicians

Practice addresses (Care Compare)

201 E Sample Rd
Pompano Beach, FL 33064-3502
Phone (954) 941-8300

Hospital & facility affiliations

  • Trust USA Home Health LLC Home health agency, Plantation, FL, CCN 109594
  • Broward Health North Hospital, Deerfield Beach, FL, CCN 100086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS9136FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medicine Services, LLC. CurrentSince Dec 1, 2023 Accepting new patients
North Broward Hospitalist Inc Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Firaz R Hosein DO PA Internal Medicine Past Accepting new patients

Locations

9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 3

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1417938499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE RD",
            "address_2": "#201",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330643547",
            "telephone_number": "954-782-3170",
            "fax_number": "954-782-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE RD",
            "address_2": "#201",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330643547",
            "telephone_number": "954-782-3170",
            "fax_number": "954-782-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPADHIAYA",
        "first_name": "AMIT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS9136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270704700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.