Individual provider Active NPI

Stephen Michael Upham, MD

  • Family Medicine Physician
  • Hartford, CT
National Provider Identifier
1750509493
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
022566 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06102-8000
Phone
(860) 545-3498
Fax
(860) 545-5035
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 022566 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06102-8000

Mailing address

PO Box 7720
Credentialing Specialist
New Haven, CT 06519-0720
Phone (203) 503-3174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180822001508 CT Practitioner - Family Practice 0446509582 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022566CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation CurrentSince Aug 20, 2018 Accepting new patients

Locations

121 Wakelee Ave
Ansonia, CT 06401
Phone (203) 503-3570

226 Dixwell Ave
New Haven, CT 06511
Phone (203) 503-3470

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

150 Sargent Dr
New Haven, CT 06511
Phone (203) 781-4100

232 Cedar St
New Haven, CT 06519
Phone (203) 503-3300

122 Wilmot Rd
New Haven, CT 06515
Phone (203) 503-3741

Organizations & group practices 1

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1750509493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7720",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065190720",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-545-3498",
            "fax_number": "860-545-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHAM",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "022566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.