Physician Compare National (NPI:1962432039)

HEALTHCARE PROVIDER: MANISH R UPADHYAY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1962432039
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7315014669
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080929000263
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	UPADHYAY
	Individual professional last name
Provider First Name	MANISH
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	508 GIBSON DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 270
	Group Practice or individual's line 2 address
City	ROSEVILLE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	956785795
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050309
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SUTTER ROSEVILLE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050108
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUTTER MEDICAL CENTER, SACRAMENTO
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050498
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SUTTER AUBURN FAITH HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	050599
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	050150
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	SIERRA NEVADA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1962432039)

HEALTHCARE PROVIDER: MANISH R UPADHYAY MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information