PRASHANT K UPADHYAYA MD
NPI 1861699506
Surgery - Plastic and Reconstructive Surgery in Round Rock, TX
About Prashant K Upadhyaya Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRASHANT K UPADHYAYA MD (NPI 1861699506) is an individual plastic and reconstructive surgery provider in Round Rock, Texas, licensed in Texas (P4722) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Ascension Seton Williamson, and is a graduate of Other (2001).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Prashant K Upadhyaya 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.
Medicare Billing Reassignment
Medicare enrollment records show Prashant Upadhyaya reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Austin, TX 78758
- Reassigned Medicare billing, Texas enrollment
- 1,188 clinicians in this Medicare group
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 3
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension Seton Williamson
Acute Care Hospitals · Round Rock, TXMedicare 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
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROUND ROCK, TX 78665
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 Prashant Upadhyaya's NPI number?
The NPI number for Prashant Upadhyaya is 1861699506. It was assigned to this individual provider in the NPPES registry on June 27, 2007.
Where is Prashant Upadhyaya located?
Prashant Upadhyaya practices at 301 Seton Pkwy Ste 103, Round Rock, TX 78665. The listed phone number is (512) 324-4815.
What is Prashant Upadhyaya's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.
Is Prashant Upadhyaya enrolled in Medicare?
Yes. Prashant Upadhyaya 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.
Which organization bills Medicare for Prashant Upadhyaya's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Prashant Upadhyaya reassigns Medicare benefits to Seton Family Of Doctors (Austin, TX). The 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 Prashant Upadhyaya's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Prashant Upadhyaya accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Prashant Upadhyaya 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 Prashant Upadhyaya affiliated with any hospitals?
According to CMS data, Prashant Upadhyaya is affiliated with Ascension Seton Williamson.
When was this NPI record last updated?
The NPPES record for Prashant Upadhyaya was last updated on August 25, 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.
# Prashant K Upadhyaya, MD · NPI 1861699506
Plastic and Reconstructive Surgery physician in Round Rock, Texas. Individual provider, active in the CMS NPPES registry since June 27, 2007.
## Identity
- **NPI:** 1861699506 (Entity type: Individual)
- **Enumerated:** June 27, 2007
- **Primary specialty:** Surgery - Plastic and Reconstructive Surgery · taxonomy 2086S0122X
- **State license:** P4722 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 301 SETON PKWY STE 103, Round Rock, TX 78665-8003
- **Phone:** (512) 324-4815
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Seton Family Of Doctors (NPI 1225644065, Austin, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2001
## Record status
- **NPPES last updated:** August 25, 2022
- **Other identifiers:** Medicaid 03586041 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1861699506) · Data from the CMS NPPES public registry.