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JOHN D UPDEGROVE MD
NPI 1518933308
Internal Medicine - Pulmonary Disease in Corsicana, TX

Active since February 23, 2006PECOS EnrolledAccepts Medicare Assignment
2457 NE COUNTY ROAD 0080, CORSICANA, TX 75109(903) 654-0457 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About John D Updegrove Md NPPES

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

JOHN D UPDEGROVE MD (NPI 1518933308) is an individual pulmonary disease provider in Corsicana, Texas, licensed in Texas (H0897) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Chi St Joseph Health Regional Hospital, and is a graduate of University Of Texas Medical Branch At Galveston (1985).

NPPES Registry Identity

NPI1518933308
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameJOHN D UPDEGROVECredential: MD
Location Address2457 NE COUNTY ROAD 0080Corsicana, TX 75109-8414
Mailing Address2457 Ne County Road 0080Corsicana, TX 75109-8414
Phone(903) 654-0457
Sole ProprietorYes
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 1985
Enumeration DateFebruary 23, 2006
Last NPPES UpdateMay 6, 2020
NPPES CertifiedMay 6, 2020
✔ NPI 1518933308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in TX · H0897
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 MedicineTaxonomy 207R00000X · License H0897 (TX)
2457 NE COUNTY ROAD 0080, Corsicana, TX 75109
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Other Identifiers 1

Medicaid136617111TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

John D Updegrove 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 ID2860476116
PECOS Enrollment IDI20040809000607
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
62 services40 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
29 services17 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
25 services19 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Chi St Joseph Health Regional Hospital

Acute Care Hospitals · Bryan, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450011
Location2801 Franciscan DrBryan, TX 77802 · Brazos County
Emergency services Birthing friendly

Ascension Providence

Acute Care Hospitals · Waco, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450042
Location6901 Medical ParkwayWaco, TX 76712 · Mc Lennan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75109 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
99%69 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 10

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

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
1 supplier21 claims21 services$114.25 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
1 supplier25 claims75 services$43.89 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
2 suppliers27 claims162 services$21.12 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
2 suppliers44 claims44 services$66.68 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers40 claims40 services$21.02 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
3 suppliers48 claims48 services$19.76 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 John Updegrove's NPI number?

The NPI number for John Updegrove is 1518933308. It was assigned to this individual provider in the NPPES registry on February 23, 2006.

Where is John Updegrove located?

John Updegrove practices at 2457 NE County Road 0080, Corsicana, TX 75109. The listed phone number is (903) 654-0457.

What is John Updegrove's specialty?

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

Is John Updegrove enrolled in Medicare?

Yes. John Updegrove 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 John Updegrove accept?

Health plans from Blue Cross and Blue Shield of Texas list John Updegrove 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 John Updegrove affiliated with any hospitals?

According to CMS data, John Updegrove is affiliated with Chi St Joseph Health Regional Hospital and Ascension Providence.

When was this NPI record last updated?

The NPPES record for John Updegrove was last updated on May 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.