Individual provider Active NPI

David Joseph Uptmore Jr., MD

  • Dermatology Physician
  • Katy, TX
National Provider Identifier
1649317819
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M4611 Issued in TX
Practice address
21310 Provincial Blvd
Suite 395
Katy, TX 77450-7580
Phone
(281) 599-0404
Fax
(281) 599-1655
NPI assigned
Jan 30, 2007
Last updated
Sep 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X M4611 TX Primary

Addresses

Primary practice location

21310 Provincial Blvd
Suite 395
Katy, TX 77450-7580

Mailing address

21310 Provincial Blvd
Suite 395
Katy, TX 77450-7580
Phone (281) 599-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070622000398 TX Practitioner - Dermatology 8426157058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katy Dermatology, P.a.Group PAC ID 4789654815, 6 clinicians

Practice addresses (Care Compare)

21310 Provincial Blvd
Katy, TX 77450-7580
Phone (281) 599-0404

24612 Kingsland Blvd
Katy, TX 77494-3386
Phone (281) 665-7097

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Removal of skin lesions552
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M4611TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Katy Dermatology, P.a. CurrentSince Dec 22, 2008 Accepting new patients
Greg Willaim Pearson, MD Dermatology Past Accepting new patients
Memorial City Cardiology Associates PA Past Accepting new patients
Advanced Dermatologic Surgery PA Dermatology Past Accepting new patients
Dermatology Group of SL PA Dermatology Past Accepting new patients

Locations

21310 Provincial Blvd
Katy, TX 77450
Phone (281) 599-0404

21310 Provincial Blvd
Ste 395
Katy, TX 77450
Phone (281) 599-0404

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1649317819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21310 PROVINCIAL BLVD",
            "address_2": "SUITE 395",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-599-0404",
            "fax_number": "281-599-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21310 PROVINCIAL BLVD",
            "address_2": "SUITE 395",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-599-0404",
            "fax_number": "281-599-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPTMORE",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M4611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.