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MADHURI UPPALAPATI M.D.
NPI 1316470743
Family Medicine - Sleep Medicine in Woodridge, IL

Active since April 04, 2017PECOS EnrolledAccepts Medicare Assignment
55.42/100
CMS Quality Rating
7530 WOODWARD AVE STE A, WOODRIDGE, IL 60517(630) 484-5911 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 21, 2025, Sep 17, 2024, Oct 26, 2022 (3 updates tracked since 2022).

About Madhuri Uppalapati M.d. NPPES

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

MADHURI UPPALAPATI M.D. (NPI 1316470743) is an individual sleep medicine provider in Woodridge, Illinois, licensed in Illinois (036.158451) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Rochester, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1316470743
Entity TypeIndividualFemale
Primary Taxonomy207QS1201X
Provider Legal NameMADHURI UPPALAPATICredential: M.D.
Location Address7530 WOODWARD AVE STE AWoodridge, IL 60517-3100
Mailing Address7530 Woodward Ave Ste AWoodridge, IL 60517-3100 · (630) 484-5911
Phone(630) 484-5911
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 4, 2017
Last NPPES UpdateMay 21, 20253 updates tracked since enumeration
NPPES CertifiedMay 21, 2025
✔ NPI 1316470743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS1201X
Licenses✔ Licensed in IL · 036.158451✔ Licensed in MN · 77813
Definition
A Family Medicine Physician 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 ListedFamily MedicineTaxonomy 207Q00000X · License 036158451 (IL)
7530 WOODWARD AVE STE A, Woodridge, IL 60517
Open in Google Maps ↗

Secondary Practice Location 1

Location 14303 Highway 52 NRochester, MN 55901-4154 · Phone (507) 287-2714

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Madhuri Uppalapati 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 ID7618246786
PECOS Enrollment IDI20211217001789, I20251008002900
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

4

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

Sleep Matters, Ltd.
Same address
Sleep Medicine
7530 WOODWARD AVE STE A
Woodridge, IL 60517
  • Reassigned Medicare billing, Illinois enrollment
  • 3 clinicians in this Medicare group
NPI 1871223065 (630) 297-8282
Cook County
14 mi
Primary Care
1800 S. HARLEM AVE
Riverside, IL 60546
  • Reassigned Medicare billing, Illinois enrollment
  • 1,047 clinicians in this Medicare group
NPI 1497875298 (708) 783-9800
Narendra R Kumar M.D, PC
239 mi
Otolaryngology
4701 TOWNE CENTRE RD, STE 201
Saginaw, MI 48604
  • Reassigned Medicare billing, Michigan enrollment
  • Medicare enrollment name: Narendra R Kumar MD PC
  • 8 clinicians in this Medicare group
NPI 1417039603 (989) 793-1040
Sound A Sleep Plc
239 mi
Sleep Medicine
4701 TOWNE CENTRE RD, SUITE 203
Saginaw, MI 48604
  • Reassigned Medicare billing, Michigan enrollment
  • 3 clinicians in this Medicare group
NPI 1174576102 (989) 792-2792

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 7

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 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.
60 services53 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.
26 services26 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.
24 services23 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
22 services22 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.
19 services19 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.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60517 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

55.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality20.58
Promoting Interoperability97
Improvement Activities40

Reported Quality Measures

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%77 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
28%2,076 patients1/55-star benchmark: 100%
e-Prescribing
96%70 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
96%1,072 patients4/55-star benchmark: 98%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 64% · 150 patients
64%150 patients
Provide Patients Electronic Access to Their Health Information
93%2,001 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.

Referred Medical Equipment & Supplies CMS DME claims 14

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
13 suppliers134 claims134 services$34.64 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
10 suppliers59 claims59 services$70.44 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
10 suppliers51 claims77 services$27.91 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
11 suppliers57 claims194 services$15.53 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
7 suppliers31 claims129 services$13.68 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
12 suppliers88 claims88 services$47.53 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 5

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

WINSTON THEIN-WAI M.D
Internal Medicine (Endocrinology, Diabetes & Metabolism)
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 910-1177
DR. PUJA SETHI M.D.
Family Medicine (Sleep Medicine)
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 297-8282
SLEEP MATTERS, LTD.
Family Medicine (Sleep Medicine)
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 297-8282
TESS SAIBERT
Pediatrics
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 910-1177
VIJAYKUMAR C PATEL, M.D
Family Medicine
7530 WOODWARD AVE STE A
WOODRIDGE, IL 60517
Dupage County (630) 910-1177

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 Madhuri Uppalapati's NPI number?

The NPI number for Madhuri Uppalapati is 1316470743. It was assigned to this individual provider in the NPPES registry on April 4, 2017.

Where is Madhuri Uppalapati located?

Madhuri Uppalapati practices at 7530 Woodward Ave Ste A, Woodridge, IL 60517. The listed phone number is (630) 484-5911.

What is Madhuri Uppalapati's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sleep Medicine, with taxonomy code 207QS1201X.

Is Madhuri Uppalapati enrolled in Medicare?

Yes. Madhuri Uppalapati 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 Madhuri Uppalapati's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Madhuri Uppalapati reassigns Medicare benefits to 4 organizations: Sleep Matters, Ltd. (Woodridge, IL), Cook County (Riverside, IL), Narendra R Kumar M.D, PC (Saginaw, MI) and Sound A Sleep Plc (Saginaw, MI). 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 Madhuri Uppalapati's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Madhuri Uppalapati accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Care Network of Michigan and 2 other insurers list Madhuri Uppalapati 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 Madhuri Uppalapati was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.