DR. RAGHU PISHKA UPENDER MD
NPI 1154303592
Psychiatry & Neurology - Sleep Medicine in Nashville, TN

Active since November 18, 2005PECOS EnrolledAccepts Medicare Assignment
97.12/100
CMS Quality Rating
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232(615) 322-3000(615) 936-0605 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 16, 2025, Mar 5, 2025, Mar 8, 2021 and 1 more (4 updates tracked since 2020).

About Dr. Raghu Pishka Upender Md NPPES

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

DR. RAGHU PISHKA UPENDER MD (NPI 1154303592) is an individual sleep medicine provider in Nashville, Tennessee, licensed in Tennessee (39248) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Vanderbilt University Medical Center, and is a graduate of University Of Connecticut School Of Medicine (1995).

NPPES Registry Identity

NPI1154303592
Entity TypeIndividualMale
Primary Taxonomy2084S0012X
Provider Legal NameDR. RAGHU PISHKA UPENDERCredential: MD
Location Address3601 THE VANDERBILT CLINICNashville, TN 37232-0001
Mailing Address3841 Green Hills Village Dr Ste 200Nashville, TN 37215-2691 · Fax (615) 322-5048
Fax(615) 936-0605
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 1995
Enumeration DateNovember 18, 2005
Last NPPES UpdateDecember 16, 20254 updates tracked since enumeration
NPPES CertifiedDecember 16, 2025
NPI 1154303592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychiatry & Neurology · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2084S0012X
License Licensed in TN · 39248
Definition

A Psychiatrist or Neurologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.

Also ListedElectrodiagnostic MedicineTaxonomy 204R00000X · License 39248 (TN)
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 39248 (TN)
3601 THE VANDERBILT CLINIC, Nashville, TN 37232

Other Identifiers 4

Other331101815TN · Commerical
Medicaid3325392TN
Other4095150TN · Tenncare
Other4095150TN · Bcbs

Accepted 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. Raghu Pishka Upender 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 ID3375506843
PECOS Enrollment IDI20041203000829
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 9

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
89 services89 patients
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.
73 services68 patients
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.
48 services46 patients
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation G0399
A Home Sleep Test (HST) with a Type III Portable Monitor is an unattended test that records your breathing, heart rate, and oxygen levels during sleep. This test uses a minimum of 4 channels to monitor these parameters, helping to diagnose sleep disorders.
40 services39 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
35 services34 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
29 services29 patients

Hospital Affiliations CMS Care Compare 3

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

Vanderbilt University Medical Center

Acute Care Hospitals · Nashville, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440039
Location1211 Medical Center DriveNashville, TN 37232 · Davidson County
Emergency services Birthing friendly

Vanderbilt Tullahoma-Harton Hospital

Acute Care Hospitals · Tullahoma, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number440144
Location1801 N Jackson St Box 460Tullahoma, TN 37388 · Coffee County
Emergency services Birthing friendly

Vanderbilt Wilson County Hospital

Acute Care Hospitals · Lebanon, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440193
Location1411 Baddour ParkwayLebanon, TN 37087 · Wilson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37232 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

97.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.64
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 17

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
21 suppliers155 claims155 services$32.26 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
26 suppliers153 claims153 services$85.32 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
24 suppliers136 claims345 services$32.59 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
30 suppliers140 claims736 services$16.85 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
23 suppliers82 claims442 services$12.82 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
36 suppliers229 claims229 services$47.14 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.

Pediatrics (Pediatric Cardiology)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Nurse Practitioner (Acute Care)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Nurse Practitioner (Pediatrics)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Internal Medicine (Pulmonary Disease)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Family Medicine
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Psychologist (Clinical Child & Adolescent)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Nurse Practitioner
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232
Surgery (Surgical Oncology)
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 37232

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 Raghu Upender's NPI number?

The NPI number for Raghu Upender is 1154303592. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Where is Raghu Upender located?

Raghu Upender practices at 3601 The Vanderbilt Clinic, Nashville, TN 37232. The listed phone number is (615) 322-3000.

What is Raghu Upender's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Sleep Medicine, with taxonomy code 2084S0012X.

Is Raghu Upender enrolled in Medicare?

Yes. Raghu Upender 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.

What insurance does Raghu Upender accept?

Health plans from Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and Ambetter of Alabama and 4 other insurers list Raghu Upender 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 Raghu Upender affiliated with any hospitals?

According to CMS data, Raghu Upender is affiliated with Vanderbilt University Medical Center, Vanderbilt Tullahoma-Harton Hospital and Vanderbilt Wilson County Hospital.

When was this NPI record last updated?

The NPPES record for Raghu Upender was last updated on December 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.