DR. SANJIV UPADHYAY M.D.
NPI 1215987961
Otolaryngology in Aurora, IL

Q: What is Sanjiv Upadhyay's NPI number?

The NPI number for Sanjiv Upadhyay is 1215987961. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Q: What is Sanjiv Upadhyay's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Sanjiv Upadhyay was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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 12, 2006PECOS Enrolled

2040 OGDEN AVE STE 401, AURORA, IL 60504(630) 978-6895(630) 753-2905 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 5, 2024, Jul 21, 2020, Feb 7, 2019 and 1 more (4 updates tracked since 2017).

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About Dr. Sanjiv Upadhyay M.d. NPPES

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

DR. SANJIV UPADHYAY M.D. (NPI 1215987961) is an individual otolaryngology provider in Aurora, Illinois, licensed in Illinois (036107658) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Copley Memorial Hospital, and is a graduate of Wayne State University School Of Medicine (1991).

NPPES Registry Identity

NPI1215987961

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameDR. SANJIV UPADHYAYCredential: M.D.

Location Address2040 OGDEN AVE STE 401Aurora, IL 60504-7208

Mailing Address2040 Ogden Ave Ste 401Aurora, IL 60504-7208 · (630) 978-6895 · Fax (630) 375-2905

Phone(630) 978-6895

Fax(630) 753-2905

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 1991

Enumeration DateMay 12, 2006

Last NPPES UpdateNovember 5, 20244 updates tracked since enumeration

NPPES CertifiedNovember 5, 2024

✔ NPI 1215987961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in IL · 036107658

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

2040 OGDEN AVE STE 401, Aurora, IL 60504

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Other Identifiers 1

Medicaid036107658IL

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sanjiv Upadhyay M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6800859612

PECOS Enrollment IDI20041120000088

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

Medicare enrollment records show Sanjiv Upadhyay reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Copley Memorial Hospital, Inc.

Same address

Endocrinology, Diabetes & Metabolism

2040 OGDEN AVE STE 217
Aurora, IL 60504

Reassigned Medicare billing, Illinois enrollment
79 clinicians in this Medicare group

NPI 1619466034 (630) 499-4721

Rush-Copley Medical Group

Same address

Obstetrics

2040 OGDEN AVE, SUITE 201
Aurora, IL 60504

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Rush-Copley Medical Group Nfp
171 clinicians in this Medicare group

NPI 1013018340 (630) 978-6886

Rush University Medical Center

19 mi

Internal Medicine

2011 YORK ROAD, 2ND FLOOR
Oak Brook, IL 60523

Reassigned Medicare billing, Illinois enrollment
Medicare enrollment name: Rush University Medical Group
2,169 clinicians in this Medicare group

NPI 1801375696 (630) 724-1310

Rush Medical Group

33 mi

Internal Medicine

1620 W HARRISON ST
Chicago, IL 60612

Reassigned Medicare billing, Illinois enrollment
548 clinicians in this Medicare group

NPI 1467312850 (312) 942-5000

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 15

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 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.

184 services148 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

136 services136 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

124 services97 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

101 services88 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

69 services69 patients

Removal of impacted ear wax 69210

53 services47 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

40 services33 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.

34 services32 patients

Diagnostic exam of voice box using a flexible endoscope 31575

30 services25 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

22 services20 patients

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.

20 services20 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.

16 services15 patients

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268

This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.

14 services14 patients

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268

14 services14 patients

Simple control of nose bleed 30901

Simple control of a nose bleed involves leaning forward slightly to prevent blood from flowing down the throat. Pinch your nostrils together and breathe through your mouth. This pressure can help the blood clot and stop the bleeding. Avoid lying down or blowing your nose.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Copley Memorial Hospital

Acute Care Hospitals · Aurora, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140029

Location2000 Ogden AvenueAurora, IL 60504 · Kane County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60504 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

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MRS. SONAL MUKESH PATEL APRN DNP

Nurse Practitioner (Gerontology)