DR. PRAKASH UPRETI MD
NPI 1003468620
Hospitalist in Rochester, NY

Active since July 13, 2019PECOS EnrolledAccepts Medicare Assignment
95.19/100
CMS Quality Rating
1425 PORTLAND AVE, ROCHESTER, NY 14621(295) 029-8769 Get Directions Write a Review

NPPES record last updated: September 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 28, 2022, Jul 13, 2019 (2 updates tracked since 2019).

About Dr. Prakash Upreti Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRAKASH UPRETI MD (NPI 1003468620) is an individual hospitalist provider in Rochester, New York, licensed in New York (317858) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with United Memorial Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1003468620
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameDR. PRAKASH UPRETICredential: MD
Location Address1425 PORTLAND AVERochester, NY 14621-3011
Mailing Address235 Greystone Ln Apt 6Rochester, NY 14618-5126 · (929) 502-9876
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 13, 2019
Last NPPES UpdateSeptember 28, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2022
NPI 1003468620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in NY · 317858
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 317858 (NY)
1425 PORTLAND AVE, Rochester, NY 14621

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Prakash Upreti Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022487149
PECOS Enrollment IDI20221213001196
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
98 services48 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
88 services85 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

United Memorial Medical Center

Acute Care Hospitals · Batavia, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330073
Location127 North StreetBatavia, NY 14020 · Genesee County
Emergency services Birthing friendly

Rochester General Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330125
Location1425 Portland AvenueRochester, NY 14621 · Monroe County
Emergency services Birthing friendly

Unity Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330226
Location1555 Long Pond RoadRochester, NY 14626 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14621 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality70.62
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Anesthesiology
1425 PORTLAND AVE
ROCHESTER, NY 14621
Physician Assistant
1425 PORTLAND AVE, BOX 362
ROCHESTER, NY 14621
Emergency Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Emergency Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Internal Medicine (Hematology)
1425 PORTLAND AVE
ROCHESTER, NY 14621
Hospitalist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Physician Assistant
1425 PORTLAND AVE
ROCHESTER, NY 14621

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prakash Upreti's NPI number?

The NPI number for Prakash Upreti is 1003468620. It was assigned to this individual provider in the NPPES registry on July 13, 2019.

Where is Prakash Upreti located?

Prakash Upreti practices at 1425 Portland Ave, Rochester, NY 14621. The listed phone number is (295) 029-8769.

What is Prakash Upreti's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Prakash Upreti enrolled in Medicare?

Yes. Prakash Upreti is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Prakash Upreti affiliated with any hospitals?

According to CMS data, Prakash Upreti is affiliated with United Memorial Medical Center, Rochester General Hospital and Unity Hospital.

When was this NPI record last updated?

The NPPES record for Prakash Upreti was last updated on September 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.