NPIMap

Individual provider Active NPI

Brandi E Upton, MD

  • Vascular Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1457561789
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
301188 Issued in NY
Practice address
577 Prospect Ave
Brooklyn, NY 11215-6065
Phone
(718) 369-1444
Fax
(718) 369-3066
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2013032805 MO
Vascular Surgery Physician 2086S0129X 2013032805 MO
Vascular Surgery Physician 2086S0129X 301188 NY Primary

Addresses

Primary practice location

577 Prospect Ave
Brooklyn, NY 11215-6065

Mailing address

PO Box 416173
Boston, MA 02241-6173
Phone (610) 644-8900

Other practice location 1

2115 S Fremont Ave
Suite 5000
Springfield, MO 65804-2239
Phone (417) 820-3960

Other identifiers 3

IdentifierTypeStateIssuer
06129822MedicaidNY
07933MedicaidLA
1457561789MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131125000082 MO Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Thoracic Surgery 5991931867 Reassigns benefits to 2 organizations
I20161109002333 CA Practitioner - Vascular Surgery 5991931867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2115 S Fremont Ave
5000 MC Vascular Surgery Springfield
Springfield, MO 65804-2230
Phone (417) 820-3912

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013032805MOMDSurgery Physician
301188NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Focus ASC LLC CurrentSince Dec 12, 2021 Accepting new patients
Mercy Hospital Springfield Current Accepting new patients
Northbay Healthcare Group CurrentSince Nov 1, 2016 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 13, 2025 Accepting new patients
Northbay Healthcare Group CurrentSince Nov 1, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1860 Pennsylvania Ave
Ste 110
Fairfield, CA 94533
Phone (707) 254-9693

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1860 Pennsylvania Ave
Ste 120
Fairfield, CA 94533
Phone (707) 426-4696

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 5000
Springfield, MO 65804
Phone (417) 820-3912

960 40th St
Brooklyn, NY 11219
Phone (718) 369-1444

Interoperability endpoints

  • Direct secure messaging: brandi.upton.d1.p30@direct.aac.nextgenshare.com
  • Direct secure messaging: brandi.upton.p31@direct.aac.nextgenshare.com
  • Direct secure messaging: bupton361479@directb.mercy.net

Organizations & group practices 9

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 9

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1457561789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416173",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416173",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 PROSPECT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156065",
            "telephone_number": "718-369-1444",
            "fax_number": "718-369-3066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 S Fremont Ave",
            "address_2": "Suite 5000",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042239",
            "country_code": "US",
            "telephone_number": "417-820-3960",
            "fax_number": "417-820-3966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UPTON",
        "first_name": "BRANDI",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2013032805",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2013032805",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "301188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06129822",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07933",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457561789",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.