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

Q: 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.

Q: What is Naresh Upadhyay's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Naresh Upadhyay was last updated on February 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

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: October 18, 2026.

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

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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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Naresh Upadhyay reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Vraj, Ltd

8.1 mi

Pulmonary Disease

2315 E 93RD ST STE 237
Chicago, IL 60617

Reassigned Medicare billing, Illinois and Indiana enrollments

NPI 1669486635 (847) 768-8925

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 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

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

30 suppliers263 claims263 services$15.61 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

17 suppliers122 claims124 services$9.99 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

29 suppliers452 claims2,467 services$1.79 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

12 suppliers53 claims53 services$5.57 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

27 suppliers200 claims200 services$11.21 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers22 claims22 services$14.70 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$907.03 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

9 suppliers22 claims22 services$113.12 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

9 suppliers114 claims114 services$10.58 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers26 claims26 services$3.43 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

17 suppliers355 claims356 services$28.12 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

8 suppliers101 claims101 services$63.23 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers52 claims52 services$31.05 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

8 suppliers24 claims6,594 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

4 suppliers12 claims2,190 services$0.07 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

3 suppliers27 claims27 services$29.55 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

8 suppliers25 claims25 services$22.93 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.

Which organization bills Medicare for Naresh Upadhyay's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Naresh Upadhyay reassigns Medicare benefits to Vraj, Ltd (Chicago, IL). The 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 Naresh Upadhyay's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Naresh Upadhyay accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.