ANUPAMA UPADHYAY M.D.
NPI 1467407890
Psychiatry & Neurology - Psychiatry in Dubuque, IA

NPI Status: Active since May 24, 2006

Contact Information

1000 LANGWORTHY ST
DUBUQUE, IA
ZIP 52001
Phone: (563) 584-3500
Fax: (563) 584-3520

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  • Individual
  • Female
  • Years of Experience 29
  • Psychiatry & Neurology
  • Psychiatry
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ANUPAMA UPADHYAY

This page provides the complete NPI Profile along with additional information for Anupama Upadhyay, a provider established in Dubuque, Iowa with a medical specialization in Psychiatry & Neurology, focusing in psychiatry and more than 29 years of experience. The healthcare provider is registered in the NPI registry with number 1467407890 assigned on May 2006. The practitioner's primary taxonomy code is 2084P0800X with license number 35340 (IA). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI
1467407890
Provider Name
ANUPAMA UPADHYAY M.D.
Gender
Female
Entity Type
Individual
Location Address
1000 LANGWORTHY ST DUBUQUE, IA 52001
Location Phone
(563) 584-3500
Location Fax
(563) 584-3520
Mailing Address
1500 ASSOCIATES DR DUBUQUE, IA 52002
Mailing Phone
(563) 584-4100
Mailing Fax
(563) 584-3520
Medical School Name
OTHER
Graduation Year
1997
Is Sole Proprietor?
Yes
Enumeration Date
05-24-2006
Last Update Date
07-08-2007
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A psychiatrist like Anupama Upadhyay are primary mental health physicians diagnose and treat mental illnesses through psychotherapy, psychoanalysis, hospitalization and medication. Psychiatrist help patients find solutions through changes in their behavioral patterns, explorations of experiences, group and family therapy.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Psychiatry

Taxonomy Code
2084P0800X
Type
Allopathic & Osteopathic Physicians
License No.
35340
License State
IA
Taxonomy Description
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12084P0800XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Psychiatry

47601 (WI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • HMO Bronze $0 Medical Deductible - HMO
  • HMO Bronze 7500 - HMO
  • HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
  • HMO Gold 1500 - HMO
  • HMO Gold 2400 - HMO
  • HMO HDHP Bronze 7200 - HMO
  • HMO HDHP Silver 5400 - HMO
  • HMO Silver 5000 - HMO
  • HMO Silver 6600 - HMO
  • POS Bronze 7500 - POS
  • Blue Choice Preferred Bronze PPO? 201 - PPO
  • Blue Choice Preferred Bronze PPO? 701 - PPO
  • Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
  • Blue Choice Preferred Gold PPO? 204 - PPO
  • Blue Choice Preferred Gold PPO? 901 - PPO
  • Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
  • Blue Choice Preferred Security PPO? 200 - PPO
  • Blue Choice Preferred Silver PPO? 203 - PPO
  • Blue Choice Preferred Silver PPO? 801 - PPO
  • Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
  • Connect Bronze 2000 Indiv Med Deductible - HMO
  • Connect Bronze 5000 Indiv Med Deductible - Rx Copay - HMO
  • Connect Bronze CMS Standard - HMO
  • Connect Gold CMS Standard - Rx Copay - HMO
  • Connect Silver 3000 Indiv Med Deductible - Rx Copay - HMO
  • Connect Silver CMS Standard - HMO
  • Wellmark Bronze HDHP HMO HSA Qualified - HMO
  • Wellmark Bronze Standard | UnityPoint Health - HMO
  • Wellmark Bronze Traditional HMO - HMO
  • Wellmark Gold Primary Care | UnityPoint Health - HMO
  • Wellmark Gold Traditional HMO - HMO
  • Wellmark Silver Primary Care | UnityPoint Health - HMO
  • Wellmark Silver Traditional HMO - HMO
  • Wellmark Standard Bronze HMO - HMO
  • Wellmark Standard Gold HMO - HMO
  • Wellmark Standard Silver HMO - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
I16964MEDICARE ID-TYPE UNSPECIFIED (04)IA 
I25267MEDICARE UPIN (02) 
0478123MEDICAID (05)IA 

Medicare Participation & PECOS Enrollment Status

Anupama Upadhyay is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Anupama Upadhyay is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3173576709

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20070411000199

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 15 minutes

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.

This service was performed 157 times for 44 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 219 times for 96 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 25 times for 23 patients

Psychiatric diagnostic evaluation with medical services

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

This service was performed 101 times for 98 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $40.35 for a new patient copayment and $16.59 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 52001 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

  • Average New Patient Price $161.4
  • Minimum New Patient Price $52.96
  • Maximum New Patient Price $161.4
  • Average New Patient Copayment $40.35
  • Minimum New Patient Copayment $13.24
  • Maximum New Patient Copayment $40.35

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.36
  • Minimum Established Patient Price $16.91
  • Maximum Established Patient Price $131.98
  • Average Established Patient Copayment $16.59
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Anupama Upadhyay is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CGH MEDICAL CENTER100 EAST LEFEVRE ROAD
STERLING, IL 61081
(815) 625-0400Acute Care Hospitals
UW HEALTH1401 EAST STATE STREET
ROCKFORD, IL 61104
(815) 968-4400Acute Care Hospitals
SAINT ANTHONY MEDICAL CENTER5666 EAST STATE STREET
ROCKFORD, IL 61108
(815) 226-2000Acute Care Hospitals

Reviews for ANUPAMA UPADHYAY M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1467407890
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
241278014818
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 2 + 7 + 8 + 0 + 1 + 4 + 8 + 1 + 8 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1467407890 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083694681DR. RYAN BRADLEY STILLE M.D.
Individual
Family Medicine1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3226
1942269402DR. MARTIN D BAGBY DO
Individual
Family Medicine1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3455
1710942701 KEVIN M MULLEN MD
Individual
Pediatrics1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3440
1902855778 LOUIS PETER ALT M.D.
Individual
Otolaryngology1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3475
1679522320 CONSTANCE A. BELLAVER A.R.N.P.
Individual
Nurse Practitioner1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3430
1639128010 HONORIO JERONIMO CACERES M.D.
Individual
Internal Medicine (Infectious Disease)1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3430
1821048059 DUANE KENT CAYLOR M.D.
Individual
Family Medicine1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3455
1023068111 KIM M. EHLERS A.R.N.P.
Individual
Nurse Practitioner1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3430
1386694156 ADIB KASSAS M.D.
Individual
Psychiatry & Neurology (Psychiatry)1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3500
1093765083 JULIE T. EHLINGER A.R.N.P.
Individual
Nurse Practitioner1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3425
1023068632 SUSAN G. BUSHMAN A.R.N.P.
Individual
Nurse Practitioner1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3480
1639129281 FREDERICK SIMON ISAAK M.D.
Individual
Emergency Medicine1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3455
1770533325 MARION I HUETTNER PH.D.
Individual
Psychologist (Clinical Child & Adolescent)1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3500
1083665111 STEPHEN J. FROMMELT PH.D.
Individual
Psychologist1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3500
1053362194 JOSEPH BERNARD FULLER M.D.
Individual
Surgery1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3450
1992756902 MARTHA E GOULD PH.D.
Individual
Psychologist (Clinical Child & Adolescent)1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3441
1992757553 MARSHA HORWITZ M.D.
Individual
Psychiatry & Neurology (Neurology)1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3495
1508817131 WILLIAM B MANZEL M.D.
Individual
Internal Medicine1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3430
1801848486 THOMAS MARK JOHNSON M.D.
Individual
Internal Medicine (Cardiovascular Disease)1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3425
1174575161 MARY MARGARET OCONNELL M.D.
Individual
Family Medicine1000 LANGWORTHY ST
DUBUQUE, IA 52001
(563) 584-3455

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1467407890, enumerated in the NPI registry as an "individual" on May 24, 2006

The provider is located at 1000 Langworthy St Dubuque, Ia 52001 and the phone number is (563) 584-3500

The provider's speciality is Psychiatry & Neurology with taxonomy code 2084P0800X with a focus in Psychiatry

The provider has more than 29 years of experience.

The provider might be accepting Accepts: Aspirus Health Plan, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $161.4 with an average copayment of $40.35 for new patient appointments. Established patients should expect a typical charge of $66.36 and an average copayment of 16.59. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Follow-up hospital inpatient care per day, typically 15 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Hospital discharge day management, more than 30 minutes and Psychiatric diagnostic evaluation with medical services.

The practitioner is affiliated to the following hospital(s): CGH MEDICAL CENTER, UW HEALTH and SAINT ANTHONY MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 24, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.