DR. JOHN H UPSHAW JR. MD
NPI 1598770869
Urology in Lake Charles, LA

Q: What is John Upshaw's NPI number?

The NPI number for John Upshaw is 1598770869. It was assigned to this individual provider in the NPPES registry on July 29, 2006.

Q: What is John Upshaw's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for John Upshaw was last updated on April 28, 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 29, 2006PECOS EnrolledAccepts Medicare Assignment

94.61/100

CMS Quality Rating

2770 3RD AVE STE 240, LAKE CHARLES, LA 70601(337) 494-4656(337) 494-4657 Get Directions Write a Review

NPPES record last updated: April 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 28, 2022, Apr 20, 2022 (2 updates tracked since 2022).

On this page

About Dr. John H Upshaw Jr. Md NPPES

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

DR. JOHN H UPSHAW JR. MD (NPI 1598770869) is an individual urology provider in Lake Charles, Louisiana, licensed in Louisiana (MD.023910.R) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with West Calcasieu Cameron Hospital, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1997).

NPPES Registry Identity

NPI1598770869

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. JOHN H UPSHAW JR.Credential: MD

Location Address2770 3RD AVE STE 240Lake Charles, LA 70601-8994

Mailing AddressPo Box 122525 Dept 2525Dallas, TX 75312-0001 · (337) 494-2921 · Fax (337) 494-6523

Phone(337) 494-4656

Fax(337) 494-4657

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1997

Enumeration DateJuly 29, 2006

Last NPPES UpdateApril 28, 20222 updates tracked since enumeration

NPPES CertifiedApril 28, 2022

✔ NPI 1598770869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in LA · MD.023910.R

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

2770 3RD AVE STE 240, Lake Charles, LA 70601

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Other Identifiers 2

OtherMD.023910.RLA · State Medical License

Medicaid1577731LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health 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

Dr. John H Upshaw Jr. 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 ID9931202652

PECOS Enrollment IDI20070316000211

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 28

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.

Injection, testosterone cypionate, 1 mg J1071

Testosterone cypionate is a medication given via injection to help balance hormone levels in your body. It's typically used when your body doesn't produce enough of this hormone naturally. The 1 mg dose refers to the amount of medication in each injection.

38,780 services14 patients

Manual urinalysis test with examination using microscope, non-automated 81000

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

1,274 services740 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.

892 services625 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.

511 services387 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

348 services278 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

297 services19 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

243 services211 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

169 services135 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

126 services16 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.

97 services96 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

95 services75 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.

66 services26 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

46 services42 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.

44 services44 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

27 services11 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

26 services26 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

23 services23 patients

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.

23 services13 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

22 services19 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

22 services16 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.

21 services18 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

19 services19 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

18 services18 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

15 services14 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

13 services12 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

13 services12 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

11 services11 patients

Injection, tobramycin sulfate, up to 80 mg J3260

Tobramycin sulfate is an antibiotic injection used to treat various bacterial infections. The dosage, up to 80 mg, is determined by your condition and response to treatment. It works by stopping the growth of bacteria.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

West Calcasieu Cameron Hospital

Acute Care Hospitals · Sulphur, LA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number190013

Location701 East Cypress StreetSulphur, LA 70663 · Calcasieu County

Emergency services Birthing friendly

Christus Ochsner St Patrick Hospital

Acute Care Hospitals · Lake Charles, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190027

Location524 Dr Michael Debakey DriveLake Charles, LA 70601 · Calcasieu County

Emergency services

Ochsner American Legion Hospital

Acute Care Hospitals · Jennings, LA

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190053

Location1634 Elton RoadJennings, LA 70546 · Jeffrson Davis County

Emergency services Birthing friendly

Lake Charles Memorial Hospital

Acute Care Hospitals · Lake Charles, LA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190060

Location1701 Oak Park BlvdLake Charles, LA 70601 · Calcasieu County

Emergency services Birthing friendly

Allen Parish Hospital

Acute Care Hospitals · Kinder, LA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number190133

Location108 6th AvenueKinder, LA 70648 · Allen County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70601 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

$124.60 typical visit price

range $53.43 – $164.73

Typical copayment $31.15 (range $13.35 – $41.18)

Most-billed visit code 99204

Established Patient

$67.06 typical visit price

range $16.64 – $133.62

Typical copayment $16.76 (range $4.16 – $33.40)

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.

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.

94.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

86.52

Improvement Activities

Cost

100

Reported Quality Measures

Advance Care Plan

100%1,256 patients5/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

37%59 patients2/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

100%4,623 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

71%2,370 patients3/55-star benchmark: 98%

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

70%253 patients2/55-star benchmark: 100%

Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

100%90 patients5/55-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 5

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

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

1 supplier15 claims720 services$0.09 avg. paid by Medicare

Male external catheter, with or without adhesive, disposable, each A4349

DME-Medical/Surgical Supplies · category DA000N

3 suppliers16 claims490 services$1.81 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

2 suppliers28 claims2,280 services$1.56 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

1 supplier11 claims750 services$5.04 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

3 suppliers16 claims32 services$6.02 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

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

LAKE CHARLES MEDICAL SERVICES UROLOGY LLC

Urology

2770 3RD AVE STE 240
LAKE CHARLES, LA 70601

Calcasieu Parish (337) 494-4656

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 Upshaw's NPI number?

The NPI number for John Upshaw is 1598770869. It was assigned to this individual provider in the NPPES registry on July 29, 2006.

Where is John Upshaw located?

John Upshaw practices at 2770 3rd Ave Ste 240, Lake Charles, LA 70601. The listed phone number is (337) 494-4656.

What is John Upshaw's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is John Upshaw enrolled in Medicare?

Yes. John 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 John Upshaw accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 2 other insurers list John 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 John Upshaw affiliated with any hospitals?

According to CMS data, John Upshaw is affiliated with West Calcasieu Cameron Hospital, Christus Ochsner St Patrick Hospital, Ochsner American Legion Hospital, Lake Charles Memorial Hospital and Allen Parish Hospital.

When was this NPI record last updated?

The NPPES record for John Upshaw was last updated on April 28, 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.