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NARESH K UPADHYAY MD
NPI 1326052309
Internal Medicine - Pulmonary Disease in Hammond, IN

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment
5500 S HOHMAN AVE STE 1E, HAMMOND, IN 46320(219) 852-0197(219) 937-2195 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 3, 2022, Dec 21, 2021, Dec 17, 2021 (3 updates tracked since 2021).

About Naresh K Upadhyay Md NPPES

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

NARESH K UPADHYAY MD (NPI 1326052309) is an individual pulmonary disease provider in Hammond, Indiana, licensed in Indiana (01039671A) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Advocate Trinity Hospital, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1326052309
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameNARESH K UPADHYAYCredential: MD
Location Address5500 S HOHMAN AVE STE 1EHammond, IN 46320-1962
Mailing Address10547 Misty Hill RdOrland Park, IL 60462-7439 · (847) 587-6112 · Fax (219) 937-2195
Phone(219) 852-0197
Fax(219) 937-2195
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateJuly 28, 2006
Last NPPES UpdateFebruary 3, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2022
✔ NPI 1326052309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses✔ Licensed in IN · 01039671A✔ Licensed in IL · 036083179
Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 01039671A (IN), 036083179 (IL)
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 01039671A (IN), 036083179 (IL)
5500 S HOHMAN AVE STE 1E, Hammond, IN 46320
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Other Identifiers 2

Medicaid200066830AIN
Medicaid036083179IL

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Naresh K Upadhyay 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 ID1850495516
PECOS Enrollment IDI20070406000051, I20071009000138
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 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 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.
211 services147 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.
202 services131 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
27 services27 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
27 services27 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
27 services27 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.
24 services24 patients

Hospital Affiliations CMS Care Compare 3

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

Advocate Trinity Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140048
Location2320 E 93rd StChicago, IL 60617 · Cook County
Emergency services Birthing friendly

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Franciscan Health Munster

Acute Care Hospitals · Munster, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150165
Location701 Superior AveMunster, IN 46321 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46320 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Referred Medical Equipment & Supplies CMS DME claims 23

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
24 suppliers296 claims297 services$33.22 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
25 suppliers216 claims216 services$72.01 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
25 suppliers230 claims582 services$28.35 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
19 suppliers133 claims692 services$15.17 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
15 suppliers67 claims363 services$12.43 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
23 suppliers196 claims198 services$47.27 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Naresh Upadhyay's NPI number?

The NPI number for Naresh Upadhyay is 1326052309. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Naresh Upadhyay located?

Naresh Upadhyay practices at 5500 S Hohman Ave Ste 1E, Hammond, IN 46320. The listed phone number is (219) 852-0197.

What is Naresh Upadhyay's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Naresh Upadhyay enrolled in Medicare?

Yes. Naresh 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.

What insurance does Naresh Upadhyay accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Naresh 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 Naresh Upadhyay affiliated with any hospitals?

According to CMS data, Naresh Upadhyay is affiliated with Advocate Trinity Hospital, Advocate Christ Hospital & Medical Center and Franciscan Health Munster.

When was this NPI record last updated?

The NPPES record for Naresh Upadhyay was last updated on February 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.