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MATTHEW CLAY UPSHAW D.O.
NPI 1407842487
Family Medicine in Clackamas, OR

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment
82.03/100
CMS Quality Rating
10100 SE SUNNYSIDE RD, CLACKAMAS, OR 97015(800) 813-2000 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 18, 2026, Feb 10, 2022 (2 updates tracked since 2022).

About Matthew Clay Upshaw D.o. NPPES

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

MATTHEW CLAY UPSHAW D.O. (NPI 1407842487) is an individual family medicine provider in Clackamas, Oregon, licensed in Oregon (DO21884) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Legacy Mount Hood Medical Center, and maintains a secondary practice location in Gresham.

NPPES Registry Identity

NPI1407842487
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMATTHEW CLAY UPSHAWCredential: D.O.
Location Address10100 SE SUNNYSIDE RDClackamas, OR 97015-8970
Mailing Address500 Ne Multnomah St Ste 100Portland, OR 97232-2031 · (800) 813-2000
Phone(800) 813-2000
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 1998
Enumeration DateSeptember 23, 2005
Last NPPES UpdateMarch 18, 20262 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1407842487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in OR · DO21884✔ Licensed in WA · OP60758493
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
10100 SE SUNNYSIDE RD, Clackamas, OR 97015
Open in Google Maps ↗

Secondary Practice Location 1

Location 1400 NE Roberts AveGresham, OR 97030-7464 · Phone (503) 665-9144 · Fax (503) 665-6404

Other Identifiers 1

Medicaid287698OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Matthew Clay Upshaw D.o. 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 ID6709937220
PECOS Enrollment IDI20110106000625, I20190409001397
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 5

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.
135 services89 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
134 services94 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.
104 services73 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
46 services46 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
36 services31 patients

Hospital Affiliations CMS Care Compare

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

Legacy Mount Hood Medical Center

Acute Care Hospitals · Gresham, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380025
Location24800 SE Stark StreetGresham, OR 97030 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97015 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

82.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.43
Improvement Activities40
Cost51.53

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers18 claims35 services$5.52 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
2 suppliers20 claims20 services$65.82 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
2 suppliers15 claims3,005 services$0.03 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers14 claims14 services$22.46 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 20

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

LOREN EDWARD JENKINS M.D.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 786-8435
JENNIFER MATTSON M.D.
Internal Medicine (Cardiovascular Disease)
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (800) 813-2000
HEATHER BUFFORD CRUMMETT M.D.
Obstetrics & Gynecology
10100 SE SUNNYSIDE RD, MOUNT TALBERT MEDICAL OFFICE
CLACKAMAS, OR 97015
Clackamas County (503) 571-8163
MRS. TAMI RACHEL COCHRAN PTA
Physical Therapy Assistant
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 666-7736
CANDY CHAU
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (866) 280-1228
HEATHER CAREY RN
Registered Nurse (Ambulatory Care)
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 813-2000
ALLYSON ADAMS
Family Medicine
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (800) 813-2000
KELLY ELIZABETH JACKSON PT, DPT
Physical Therapist (Orthopedic)
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 97015
Clackamas County (503) 813-2000

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 Matthew Upshaw's NPI number?

The NPI number for Matthew Upshaw is 1407842487. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Matthew Upshaw located?

Matthew Upshaw practices at 10100 SE Sunnyside Rd, Clackamas, OR 97015. The listed phone number is (800) 813-2000.

What is Matthew Upshaw's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Matthew Upshaw enrolled in Medicare?

Yes. Matthew 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.

What insurance does Matthew Upshaw accept?

Health plans from Providence Health Plan list Matthew 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.

Is Matthew Upshaw affiliated with any hospitals?

According to CMS data, Matthew Upshaw is affiliated with Legacy Mount Hood Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Upshaw was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.