Individual provider Active NPI

Amita Manish Upadhyay, M.D., M.P.H

  • Psychiatry Physician
  • Roseville, CA
National Provider Identifier
1689859936
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A100368 Issued in CA
Practice address
508 Gibson Drive
Suite 270 a
Roseville, CA 95678-5795
Phone
(916) 771-4747
Fax
(916) 771-4745
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A100368 CA
Psychiatry Physician 2084P0800X A100368 CA Primary

Addresses

Primary practice location

508 Gibson Drive
Suite 270 a
Roseville, CA 95678-5795

Mailing address

508 Gibson Drive
Suite 270 a
Roseville, CA 95678-5795
Phone (916) 771-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141007002539 CA Practitioner - Psychiatry 9830319524

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100368CAMDMarriage & Family Therapist
A100368CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine M.D. Professional Corporation Psychiatry Past Accepting new patients
Mark David Levinem MD Sunnyvale PC Psychiatry Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1689859936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 GIBSON DRIVE",
            "address_2": "SUITE 270 A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785795",
            "telephone_number": "916-771-4747",
            "fax_number": "916-771-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 GIBSON DRIVE",
            "address_2": "SUITE 270 A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785795",
            "telephone_number": "916-771-4747",
            "fax_number": "916-771-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPADHYAY",
        "first_name": "AMITA",
        "middle_name": "MANISH",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A100368",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.