DR. HINESH UPADHYAY M.D.
NPI 1144632944
Internal Medicine - Pulmonary Disease in East Orange, NJ
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
Specialties & Licenses 4
Other Names 1
Secondary Practice Location 1
Accepted 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
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.
Medicare Billing Reassignments
7Medicare enrollment records show Hinesh Upadhyay reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
East Orange, NJ 07018
- Reassigned Medicare billing, New Jersey enrollment
- 66 clinicians in this Medicare group
Passaic, NJ 07055
- Reassigned Medicare billing, New Jersey enrollment
- 51 clinicians in this Medicare group
Cedar Knolls, NJ 07927
- Reassigned Medicare billing, New Jersey enrollment
- 33 clinicians in this Medicare group
Edison, NJ 08820
- Reassigned Medicare billing, New Jersey enrollment
Raritan, NJ 08869
- Reassigned Medicare billing, New Jersey enrollment
- 11 clinicians in this Medicare group
Clinton, NJ 08809
- Reassigned Medicare billing, New Jersey enrollment
- Medicare enrollment name: St Lukes Warren Physician Group PC
- 528 clinicians in this Medicare group
East Stroudsburg, PA 18301
- Reassigned Medicare billing, Pennsylvania enrollment
- Medicare enrollment name: St Lukes Physician Group Inc
- 2,851 clinicians in this Medicare group
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 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.
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, NJSaint Clare's Hospital/ Denville Campus
Acute Care Hospitals · Denville, NJCarewell Health Medical Center
Acute Care Hospitals · East Orange, NJJfk Medical Center
Acute Care Hospitals · Edison, NJBayshore Medical Center
Acute Care Hospitals · Holmdel, NJPhysician 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.
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.
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.
EAST ORANGE, NJ 07018
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 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.
Where is Hinesh Upadhyay located?
Hinesh Upadhyay practices at 300 Central Ave, East Orange, NJ 07018. The listed phone number is (973) 672-8400.
What is Hinesh Upadhyay's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.
Is Hinesh Upadhyay enrolled in Medicare?
Yes. Hinesh Upadhyay 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 Hinesh Upadhyay's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Hinesh Upadhyay reassigns Medicare benefits to 7 organizations: Eoh Acquisition Group, LLC (East Orange, NJ), Ccmma Nj LLC (Passaic, NJ), Advanced Cardiology, LLC (Cedar Knolls, NJ), Pulmonary Critical Care And Sleep Associates Of Somerset (Edison, NJ), Wellness First Medical Clinic LLC (Raritan, NJ) and 2 more organizations, listed in the Medicare section above. 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 Hinesh Upadhyay's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Hinesh Upadhyay accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Blue Cross and Blue Shield of Texas and Oscar Health list Hinesh Upadhyay 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 Hinesh Upadhyay affiliated with any hospitals?
According to CMS data, Hinesh Upadhyay is affiliated with Raritan Bay Medical Center, Saint Clare's Hospital/ Denville Campus, Carewell Health Medical Center, Jfk Medical Center and Bayshore Medical Center.
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 15 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.
# Dr. Hinesh Upadhyay, M.D. · NPI 1144632944
Pulmonary Disease physician in East Orange, New Jersey. Individual provider, active in the CMS NPPES registry since May 28, 2014.
## Identity
- **NPI:** 1144632944 (Entity type: Individual)
- **Enumerated:** May 28, 2014
- **Primary specialty:** Internal Medicine - Pulmonary Disease · taxonomy 207RP1001X
- **State license:** 25MA09477900 (New Jersey)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 300 CENTRAL AVE, East Orange, NJ 07018-2819
- **Phone:** (973) 672-8400
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 7 organizations under Medicare reassignment (form CMS-855R): Eoh Acquisition Group, LLC (NPI 1578922258, East Orange, NJ); Ccmma Nj LLC (NPI 1124543095, Passaic, NJ); Advanced Cardiology, LLC (NPI 1295871796, Cedar Knolls, NJ); Pulmonary Critical Care And Sleep Associates Of Somerset (NPI 1669205373, Edison, NJ); Wellness First Medical Clinic LLC (NPI 1811468457, Raritan, NJ); and 2 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** August 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1144632944) · Data from the CMS NPPES public registry.