NPIMap

Individual provider Active NPI

Jeffrey Dwight Upton, MD

  • Specialist
  • Carson City, NV
National Provider Identifier
1790744209
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5645 Issued in NV
Practice address
1525 Vista LN
120
Carson City, NV 89703-4633
Phone
(775) 885-9991
Fax
(775) 883-0884
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5645 NV Primary

Addresses

Primary practice location

1525 Vista LN
120
Carson City, NV 89703-4633

Mailing address

1525 Vista LN
Ste 120
Carson City, NV 89703-4633
Phone (775) 885-9991

Other identifiers 1

IdentifierTypeStateIssuer
20-13007MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000003 NV Practitioner - Urology 7416973516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Nevada School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carson Tahoe Physician ClinicsGroup PAC ID 1153479027, 104 clinicians
CTH Physicians ClinicGroup PAC ID 1254787203, 107 clinicians

Practice addresses (Care Compare)

1425 Vista LN
Carson City, NV 89703-4644
Phone (775) 445-6680

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5645NVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Tahoe Regional Healthcare CurrentSince Jan 28, 2024 Accepting new patients
CTH Physicians Clinic CurrentSince Jan 1, 2026 Accepting new patients
Carson Tahoe Regional Healthcare CurrentSince Jan 28, 2024 Accepting new patients
Carson Tahoe Physician Clinics CurrentSince Jan 27, 2024 Accepting new patients

Locations

2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

900 E Long St
Carson City, NV 89706
Phone (775) 884-7000

2874 N Carson St
Ste 120
Carson City, NV 89706
Phone (775) 445-5181

1425 Vista Ln
Carson City, NV 89703
Phone (775) 445-6680

901 Medical Center Dr
Ste 203
Dayton, NV 89403
Phone (775) 445-7630

10539 Professional Cir
Ste 200
Reno, NV 89521
Phone (775) 445-7026

Interoperability endpoints

  • Direct secure messaging: jupton414192@direct.med.utah.edu

Organizations & group practices 4

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 8

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1790744209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 VISTA LN",
            "address_2": "STE 120",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034633",
            "telephone_number": "775-885-9991",
            "fax_number": "775-883-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 VISTA LN",
            "address_2": "120",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034633",
            "telephone_number": "775-885-9991",
            "fax_number": "775-883-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPTON",
        "first_name": "JEFFREY",
        "middle_name": "DWIGHT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "5645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-13007",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.