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MACHIA UTHAPPA MD
NPI 1124098678
Internal Medicine in Edison, NJ

Active since January 26, 2006PECOS EnrolledAccepts Medicare Assignment
94.95/100
CMS Quality Rating
1 ETHEL RD, SUITE 107B, EDISON, NJ 08817(732) 287-2020(732) 287-2071 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Machia Uthappa Md NPPES

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

MACHIA UTHAPPA MD (NPI 1124098678) is an individual internal medicine provider in Edison, New Jersey, licensed in New Jersey (MA061302) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Jfk Medical Center, and maintains a secondary practice location in Edison.

NPPES Registry Identity

NPI1124098678
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMACHIA UTHAPPACredential: MD
Location Address1 ETHEL RD, SUITE 107BEdison, NJ 08817-2838
Mailing Address331 Newman Springs Road, Bldg. 2, Suite 220Red Bank, NJ 07701 · (732) 807-0877 · Fax (201) 751-1680
Phone(732) 287-2020
Fax(732) 287-2071
Sole ProprietorYes
Medical School CMSOtherGraduated 1986
Enumeration DateJanuary 26, 2006
Last NPPES UpdateMarch 19, 2025
NPPES CertifiedMarch 19, 2025
✔ NPI 1124098678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · MA061302
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1 ETHEL RD, Edison, NJ 08817
Open in Google Maps ↗

Secondary Practice Location 1

Location 165 James StEdison, NJ 08820-3947 · Phone (732) 287-2020 · Fax (732) 287-2071

Other Identifiers 2

Other1184722431NJ · Group Npi Number
Medicaid7894406NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Machia Uthappa 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 ID2062457997
PECOS Enrollment IDI20050622000300
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Machia Uthappa reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mid Jersey Medical Associates, PA
Same address
Primary Care
1 ETHEL RD, SUITE 107B
Edison, NJ 08817
  • Reassigned Medicare billing, New Jersey enrollment
NPI 1184722431 (732) 287-2020
Hackensack Meridian Health Medical Group - Primary Care PC
22 mi
Family Medicine
331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701
  • Reassigned Medicare billing, New Jersey enrollment
  • 689 clinicians in this Medicare group
NPI 1336203538 (732) 807-0800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
791 services350 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
336 services210 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
305 services172 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
109 services109 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
104 services104 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
68 services68 patients

Hospital Affiliations CMS Care Compare

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

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08817 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

94.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.26
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%2,001 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
89%46 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
31%1,027 patients2/55-star benchmark: 99%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
41%1,027 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
5%1,027 patients1/55-star benchmark: 59%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers52 claims125 services$5.76 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
13 suppliers24 claims36 services$0.96 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

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

HARRY COLLINS, MD LLC
Clinic/Center (Primary Care)
1 ETHEL RD, SUITE 107B
EDISON, NJ 08817
Middlesex County (732) 287-2020
DR. ROBERT J SCHANZER M.D.
Internal Medicine (Cardiovascular Disease)
1 ETHEL RD, SUITE 106D
EDISON, NJ 08817
Middlesex County (732) 650-0040
MID JERSEY MEDICAL ASSOCIATES, PA
Clinic/Center (Primary Care)
1 ETHEL RD, SUITE 107B
EDISON, NJ 08817
Middlesex County (732) 287-2020
ALLISON L FACHES MD PA
Family Medicine
1 ETHEL RD, SUITE 107B
EDISON, NJ 08817
Middlesex County (732) 452-0057
SHELENE M GROSS LCSW, LCADC
Social Worker (Clinical)
1 ETHEL RD, SUITE 101B
EDISON, NJ 08817
Middlesex County (732) 248-1805
ALLISON L FACHES MD
Family Medicine
1 ETHEL RD, SUITE 107B
EDISON, NJ 08817
Middlesex County (732) 452-0057
PRIORITY HEALTH ASSOCIATES LLC
Internal Medicine
1 ETHEL RD, SUITE 106 A
EDISON, NJ 08817
Middlesex County (908) 342-4708
ADVANCED CARDIOVASCULAR MEDICINE, LLC
Internal Medicine (Cardiovascular Disease)
1 ETHEL RD, SUITE 101D
EDISON, NJ 08817
Middlesex County (732) 650-0040

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 Machia Uthappa's NPI number?

The NPI number for Machia Uthappa is 1124098678. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Where is Machia Uthappa located?

Machia Uthappa practices at 1 Ethel Rd Suite 107B, Edison, NJ 08817. The listed phone number is (732) 287-2020.

What is Machia Uthappa's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Machia Uthappa enrolled in Medicare?

Yes. Machia Uthappa 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.

Which organizations bill Medicare for Machia Uthappa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Machia Uthappa reassigns Medicare benefits to 2 organizations: Mid Jersey Medical Associates, PA (Edison, NJ) and Hackensack Meridian Health Medical Group - Primary Care PC (Red Bank, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Machia Uthappa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Machia Uthappa accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Machia Uthappa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Machia Uthappa affiliated with any hospitals?

According to CMS data, Machia Uthappa is affiliated with Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Machia Uthappa was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.