SANJAY UPADHYAY M.D.
NPI 1538350053
Family Medicine in Philadelphia, PA

Q: What is Sanjay Upadhyay's NPI number?

The NPI number for Sanjay Upadhyay is 1538350053. It was assigned to this individual provider in the NPPES registry on August 8, 2007.

Q: What is Sanjay Upadhyay's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Sanjay Upadhyay was last updated on May 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 August 08, 2007PECOS Enrolled

1741 FRANKFORD AVE, SUITE 100A, PHILADELPHIA, PA 19125(215) 425-2424(215) 425-0342 Get Directions Write a Review

NPPES record last updated: May 30, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 30, 2017, May 9, 2017 (2 updates tracked since 2017).

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About Sanjay Upadhyay M.d. NPPES

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

SANJAY UPADHYAY M.D. (NPI 1538350053) is an individual family medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD460862) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1538350053

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSANJAY UPADHYAYCredential: M.D.

Location Address1741 FRANKFORD AVE, SUITE 100APhiladelphia, PA 19125-2445

Mailing Address2450 W Hunting Park Ave, 2nd Floor TpiPhiladelphia, PA 19129-1302 · (215) 926-9022 · Fax (215) 226-8286

Phone(215) 425-2424

Fax(215) 425-0342

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateAugust 8, 2007

Last NPPES UpdateMay 30, 20172 updates tracked since enumeration

✔ NPI 1538350053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in PA · MD460862✔ Licensed in NY · 253746

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.

1741 FRANKFORD AVE, Philadelphia, PA 19125

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Other Identifiers 2

OtherMD460862PA · License Number

Other253746NY · License#

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sanjay Upadhyay M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668657685

PECOS Enrollment IDI20110506000005, I20170616001844

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 Reassignments

Medicare enrollment records show Sanjay Upadhyay reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Morris Heights Health Center, Inc.

87 mi

Federally Qualified Health Center (FQHC)

1227 EDWARD L GRANT HWY, BRONX MEDICAL AND WELLNESS CENTER
Bronx, NY 10452

Reassigned Medicare billing, New York enrollment
98 clinicians in this Medicare group

NPI 1669912341 (718) 716-4400

Westchester Medical Group, P.C.

104 mi

Critical Care Medicine

800 WESTCHESTER AVE STE N715
Rye Brook, NY 10573

Reassigned Medicare billing, New York enrollment
470 clinicians in this Medicare group

NPI 1881653822 (908) 988-0428

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 27

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 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.

257 services186 patients

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.

180 services151 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

172 services27 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.

167 services167 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

143 services22 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.

138 services123 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

99 services94 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

78 services78 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

78 services73 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

60 services58 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

59 services57 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

54 services54 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.

39 services35 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

36 services35 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

34 services34 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

34 services34 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

28 services26 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

27 services13 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.

22 services22 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

19 services18 patients

Pneumococcal conjugate vaccine, 15 valent (pcv15), for intramuscular use 90671

The Pneumococcal Conjugate Vaccine, 15-valent (PCV15), is given through a muscle injection. It helps protect against 15 types of bacteria that can cause serious illnesses like pneumonia and meningitis. It's important for overall health and prevention.

18 services18 patients

Prostate cancer screening; prostate specific antigen test (psa) G0103

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

14 services14 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

13 services13 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

12 services12 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

12 services12 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

12 services12 patients

Coagulation assessment blood test, plasma or whole blood 85730

A coagulation assessment blood test evaluates how well your blood clots, helping identify potential bleeding or clotting disorders. This test uses a sample of your plasma or whole blood. It's a standard procedure to ensure your body's clotting process is functioning properly.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19125 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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.

Other Providers at the Same Location NPPES 11

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

TEMPLE PHYSICIANS INC

Orthopaedic Surgery

1741 FRANKFORD AVE, SUITE 100-F
PHILA, PA 19125

Philadelphia County (215) 425-2424

KEM YENAL MD

Family Medicine

1741 FRANKFORD AVE, SUITE 100A
PHILA, PA 19125

Philadelphia County (215) 425-2424

TEMPLE PHYSICIANS INC

Obstetrics & Gynecology

1741 FRANKFORD AVE, SUITE 100B
PHILADELPHIA, PA 19125

Philadelphia County (215) 425-2424

TEMPLE PHYSICIANS INC

Family Medicine

1741 FRANKFORD AVE, SUITE 100A
PHILADELPHIA, PA 19125

Philadelphia County (215) 425-2424

TEMPLE PHYSICIANS INC

Internal Medicine (Cardiovascular Disease)

1741 FRANKFORD AVE, SUITE 100-E
PHILA, PA 19125

Philadelphia County (215) 425-2424

CYRIAC THOMAS THACHET MD

Internal Medicine

1741 FRANKFORD AVE, SUITE 100A
PHILADELPHIA, PA 19125

Philadelphia County (215) 425-2424

TEMPLE PHYSICIANS INC

Internal Medicine (Gastroenterology)

1741 FRANKFORD AVE, SUITE 100C
PHILADELPHIA, PA 19125

Philadelphia County (215) 425-2424

MARC P HUROWITZ DO

Family Medicine

1741 FRANKFORD AVE, SUITE 100-A
PHILADELPHIA, PA 19125

Philadelphia County (215) 425-2424

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 Sanjay Upadhyay's NPI number?

The NPI number for Sanjay Upadhyay is 1538350053. It was assigned to this individual provider in the NPPES registry on August 8, 2007.

Where is Sanjay Upadhyay located?

Sanjay Upadhyay practices at 1741 Frankford Ave Suite 100A, Philadelphia, PA 19125. The listed phone number is (215) 425-2424.

What is Sanjay Upadhyay's specialty?

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

Is Sanjay Upadhyay enrolled in Medicare?

Yes. Sanjay Upadhyay is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sanjay Upadhyay's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sanjay Upadhyay reassigns Medicare benefits to 2 organizations: Morris Heights Health Center, Inc. (Bronx, NY) and Westchester Medical Group, P.C. (Rye Brook, NY). Each 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 Sanjay Upadhyay's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sanjay Upadhyay was last updated on May 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.