DR. HINESH UPADHYAY M.D.
NPI 1144632944
Internal Medicine - Pulmonary Disease in East Orange, NJ

Q: What is Hinesh Upadhyay's NPI number?

The NPI number for Hinesh Upadhyay is 1144632944. It was assigned to this individual provider in the NPPES registry on May 28, 2014. The provider is also known as Hineshkumar Natwarlal Upadhyay.

Q: What is Hinesh Upadhyay's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Hinesh Upadhyay was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since May 28, 2014PECOS EnrolledAccepts Medicare Assignment

300 CENTRAL AVE, EAST ORANGE, NJ 07018(973) 672-8400 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 6, 2025, Aug 20, 2024, Aug 9, 2022 and 1 more (4 updates tracked since 2018).

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About Dr. Hinesh Upadhyay M.d. NPPES

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

DR. HINESH UPADHYAY M.D. (NPI 1144632944) is an individual pulmonary disease provider in East Orange, New Jersey, licensed in New Jersey (25MA09477900) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Raritan Bay Medical Center, and maintains a secondary practice location in Edison.

NPPES Registry Identity

NPI1144632944

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. HINESH UPADHYAYCredential: M.D.

Location Address300 CENTRAL AVEEast Orange, NJ 07018-2819

Mailing Address873 Us Route 1 # 1092North Brunswick, NJ 08902-3345 · (551) 775-1820

Phone(973) 672-8400

Sole ProprietorYes

Medical School CMSOtherGraduated 2005

Enumeration DateMay 28, 2014

Last NPPES UpdateAugust 6, 20254 updates tracked since enumeration

NPPES CertifiedAugust 6, 2025

✔ NPI 1144632944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in NJ · 25MA09477900✔ Licensed in TX · R8676

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA09477900 (NJ)

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 25MA09477900 (NJ)

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 25MA09477900 (NJ)

300 CENTRAL AVE, East Orange, NJ 07018

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Other Names 1

Former Name (1)Hineshkumar Natwarlal Upadhyay

Secondary Practice Location 1

Location 165 James StEdison, NJ 08820 · Phone (732) 321-7935

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Blue Cross Blue Shield of Arizona, Medica.Insurance ›

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. Hinesh Upadhyay M.d. 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 ID7214156041

PECOS Enrollment IDI20140910000235

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 4

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

173 services92 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

74 services51 patients

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.

19 services17 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.

17 services17 patients

Hospital Affiliations CMS Care Compare 5

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

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310039

Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County

Emergency services Birthing friendly

St Luke's Warren Hospital

Acute Care Hospitals · Phillipsburg, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310060

Location185 Roseberry StPhillipsburg, NJ 08865 · Warren County

Emergency services

Carewell Health Medical Center

Acute Care Hospitals · East Orange, NJ

1/5 CMS rating

OwnershipProprietary

CMS Certification Number310083

Location300 Central AveEast Orange, NJ 07018 · Essex County

Emergency services

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

Bayshore Medical Center

Acute Care Hospitals · Holmdel, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310112

Location727 N Beers StHolmdel, NJ 07733 · Monmouth County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07018 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.

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.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers36 claims36 services$61.39 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers28 claims28 services$30.61 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 20

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

DR. JAMES N EZEMA MD

Internal Medicine