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DR. THOMAS A UPSHAW M.D.
NPI 1306002142
Psychiatry & Neurology - Psychiatry in Mount Pleasant, SC

Active since July 31, 2008PECOS EnrolledAccepts Medicare AssignmentCLIA 42D2039577 · Waiver
728 S SHELMORE BLVD STE 103, MOUNT PLEASANT, SC 29464(843) 972-0262(843) 972-0263 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Thomas A Upshaw M.d. NPPES

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

DR. THOMAS A UPSHAW M.D. (NPI 1306002142) is an individual psychiatry provider in Mount Pleasant, South Carolina, licensed in South Carolina (18101) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 11, 2028, and is a graduate of Emory University School Of Medicine (1994).

NPPES Registry Identity

NPI1306002142
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. THOMAS A UPSHAWCredential: M.D.
Location Address728 S SHELMORE BLVD STE 103Mount Pleasant, SC 29464-1601
Mailing Address728 S Shelmore Blvd Ste 103Mount Pleasant, SC 29464-1601 · (843) 972-0262 · Fax (843) 972-0263
Phone(843) 972-0262
Fax(843) 972-0263
Sole ProprietorYes
Medical School CMSEmory University School Of MedicineGraduated 1994
Enumeration DateJuly 31, 2008
Last NPPES UpdateSeptember 18, 2023
NPPES CertifiedMay 27, 2021
✔ NPI 1306002142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in SC · 18101
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
728 S SHELMORE BLVD STE 103, Mount Pleasant, SC 29464
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Other Identifiers 1

Medicaid181010SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.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. Thomas A Upshaw 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 ID4082694328
PECOS Enrollment IDI20040726000681
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2039577

Thomas Upshaw, MD PA · Mt Pleasant, SC
Active · expires Apr 11, 2028
CLIA Number42D2039577
Laboratory TypePhysician Office
Certificate Effective DateApril 12, 2026
Certificate Expiration DateApril 11, 2028
Laboratory DirectorThomas Upshaw
Laboratory Phone(843) 972-0262
Laboratory LocationThomas Upshaw, MD PA728 S Shelmore Blvd, Suite 103, Mt Pleasant, SC 29464
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

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.

Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
269 services50 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.
206 services38 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.
148 services21 patients
Psychotherapy with evaluation and management visit, 45 minutes 90836
Psychotherapy with evaluation and management is a 45-minute session where a healthcare provider discusses your mental and emotional health. They assess your current state, manage any issues, and help you develop coping strategies. This service aims to improve your overall well-being.
82 services15 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
46 services24 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
42 services42 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29464 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
$163.84 typical visit price
range $53.57 – $163.84
Typical copayment $40.96 (range $13.39 – $40.96)
Most-billed visit code 99205
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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.

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.

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder (MDD) with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified
90%158 patients4/55-star benchmark: 99%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 97% · 91 patients
Patients 4MonthsOfStart: 99% · 93 patients
98%90 patients
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%1,431 patients4/55-star benchmark: 100%
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.
100%2,357 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
92%89 patients4/55-star benchmark: 99%
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.
98%1,343 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.
88%297 patients4/55-star benchmark: 99%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
45%271 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
93%69 patients4/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 232 patients
Patients tobacco: 96% · 232 patients
33%64 patients2/55-star benchmark: 98%
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…
83%297 patients4/55-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%297 patients1/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 4% · 77 patients
5%77 patients4/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES

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

THOMAS A UPSHAW, MD, PA
Clinic/Center (Adult Mental Health)
728 S SHELMORE BLVD STE 103
MT PLEASANT, SC 29464
Charleston County (843) 972-0262

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 Thomas Upshaw's NPI number?

The NPI number for Thomas Upshaw is 1306002142. It was assigned to this individual provider in the NPPES registry on July 31, 2008.

Where is Thomas Upshaw located?

Thomas Upshaw practices at 728 S Shelmore Blvd Ste 103, Mount Pleasant, SC 29464. The listed phone number is (843) 972-0262.

What is Thomas Upshaw's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Thomas Upshaw enrolled in Medicare?

Yes. Thomas Upshaw 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.

Does Thomas Upshaw hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2039577) is associated with this NPI, valid through April 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Thomas Upshaw accept?

Health plans from BlueCross BlueShield of South Carolina list Thomas Upshaw 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.

When was this NPI record last updated?

The NPPES record for Thomas Upshaw was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.