Individual provider Active NPI

Diego Upegui

  • Physician Assistant
  • Toppenish, WA
National Provider Identifier
1467004721
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61154528 Issued in WA
Practice address
510 W 1St Ave
Toppenish, WA 98948-1564
Phone
(509) 865-5600
Fax
(509) 865-5783
NPI assigned
Jul 16, 2019
Last updated
May 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61154528 WA Primary

Addresses

Primary practice location

510 W 1St Ave
Toppenish, WA 98948-1564

Mailing address

510 W 1St Ave
Toppenish, WA 98948-1564
Phone (509) 865-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601001618 WA Practitioner - Physician Assistant 2567861180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

3801 Kern Way
Yakima, WA 98902-6340
Phone (509) 574-3200

510 W 1St Ave
Toppenish, WA 98948-1564
Phone (509) 865-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61154528WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Jun 1, 2021 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jun 1, 2021 Accepting new patients

Locations

510 W 1st Ave
Toppenish, WA 98948
Phone (509) 865-3355

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Interoperability endpoints

  • Direct secure messaging: dupegui35443@yvfwc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1467004721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W 1ST AVE",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989481564",
            "telephone_number": "509-865-5600",
            "fax_number": "509-865-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W 1ST AVE",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989481564",
            "telephone_number": "509-865-5600",
            "fax_number": "509-865-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPEGUI",
        "first_name": "DIEGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61154528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toppenish, WA

Sources for this page

Verify at the official NPI Registry.