Individual provider Active NPI

Monique Lashawne Upton, M.D.

  • Psychiatry Physician
  • Holly Hill, FL
National Provider Identifier
1669679353
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME116163 Issued in FL
Practice address
1340 Ridgewood Ave
Holly Hill, FL 32117-2320
Phone
(386) 676-7175
Fax
(386) 676-7134
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME116163 FL Primary

Addresses

Primary practice location

1340 Ridgewood Ave
Holly Hill, FL 32117-2320

Mailing address

PO Box 9671
Daytona Beach, FL 32120-9671
Phone (386) 676-7130

Other identifiers 5

IdentifierTypeStateIssuer
7100148830MedicaidKY
K226510OtherKYMEDICARE
14M8TOtherFLBCBS
1669679353OtherFLTRICARE
006241300MedicaidFL

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
I20121102000007 FL Practitioner - Psychiatry 1759433444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709
Phone (386) 254-4000

Hospital & facility affiliations

  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME116163FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saafe Behavioral Services LLC CurrentSince Dec 4, 2015 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Apr 23, 2014 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

201 W Plymouth Ave
Deland, FL 32720
Phone (386) 872-2963

Interoperability endpoints

  • Direct secure messaging: moniqueupton@fhcpfl.allscriptsdirect.net

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.

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1669679353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9671",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209671",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 RIDGEWOOD AVE",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321172320",
            "telephone_number": "386-676-7175",
            "fax_number": "386-676-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPTON",
        "first_name": "MONIQUE",
        "middle_name": "LASHAWNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME116163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100148830",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K226510",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14M8T",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1669679353",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006241300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Hill, FL

Sources for this page

Verify at the official NPI Registry.