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DAVID C. UPTON M.D.
NPI 1457397663
Otolaryngology in Madison, WI

Active since June 22, 2006PECOS EnrolledAccepts Medicare Assignment
1 S PARK ST, MADISON, WI 53715(608) 287-2500(608) 287-2550 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About David C. Upton M.d. NPPES

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

DAVID C. UPTON M.D. (NPI 1457397663) is an individual otolaryngology provider in Madison, Wisconsin, licensed in Wisconsin (50973) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of University Of Wisconsin School Of Medicine (2006).

NPPES Registry Identity

NPI1457397663
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDAVID C. UPTONCredential: M.D.
Location Address1 S PARK STMadison, WI 53715-1375
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Phone(608) 287-2500
Fax(608) 287-2550
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2006
Enumeration DateJune 22, 2006
Last NPPES UpdateJanuary 6, 2021
NPPES CertifiedJanuary 6, 2021
✔ NPI 1457397663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in WI · 50973
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1 S PARK ST, Madison, WI 53715
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW 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

David C. Upton 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 ID9234317546
PECOS Enrollment IDI20110708000300
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 4

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.
91 services88 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
77 services77 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
45 services45 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520089
Location202 S Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Sauk Prairie Hospital

Acute Care Hospitals · Prairie Du Sac, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520095
Location260 26th StreetPrairie Du Sac, WI 53578 · Sauk County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53715 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

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.

JESSICA ANN NOWAK APNP
Nurse Practitioner
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2434
DAVID M MELNICK MD
Surgery
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2100
JOHN D WEGENKE MD
Urology
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2900
ABDUL MUNEM KENJ HALABI MD
Internal Medicine (Rheumatology)
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2800
DIANE L BENZ AUD
Audiologist
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2650
LAUREN WEST APNP
Nurse Practitioner
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2037
KATHLEEN M BAUS MD
Radiology (Diagnostic Radiology)
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2050
DOROTHY ANNE IMHOFF DNP
Nurse Practitioner
1 S PARK ST
MADISON, WI 53715
Dane County (608) 287-2434

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 David Upton's NPI number?

The NPI number for David Upton is 1457397663. It was assigned to this individual provider in the NPPES registry on June 22, 2006.

Where is David Upton located?

David Upton practices at 1 S Park St, Madison, WI 53715. The listed phone number is (608) 287-2500.

What is David Upton's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is David Upton enrolled in Medicare?

Yes. David Upton 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 David Upton accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz and 1 other insurer list David Upton 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 David Upton affiliated with any hospitals?

According to CMS data, David Upton is affiliated with Unitypoint Health - Meriter, Sauk Prairie Hospital and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for David Upton was last updated on January 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.