GAURAV UPADHYAY
Clinical Cardiac Electrophysiology Physician in CHICAGO, Illinois. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What the federal data shows
GAURAV UPADHYAY reported a CMS MIPS final score of 97.7188/100 — above the 83.1 national average — and filed 638 Medicare Part D claims in 2023.
- 97.7188/100
- MIPS score · +15 vs avg
- 638
- Part D claims, 2023
- 79%
- generic prescribing
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.
GAURAV UPADHYAY's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure
98 Top 15% higher than 85% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
GAURAV UPADHYAY practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about GAURAV UPADHYAY?
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Illinois
How Clinical Cardiac Electrophysiology Physician compares to other specialties among Illinois providers
Clinical Cardiac Electrophysiology Physician share within Illinois
Clinical Cardiac Electrophysiology Physician is one of the more visible NUCC categories in Illinois
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
GAURAV UPADHYAY's 2023 MIPS final score plotted against the Clinical Cardiac Electrophysiology Physician national average
- MIPS Final Score
- 97.7188/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Clinical Cardiac Electrophysiology Physician) — 97.7188/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Specialty volume Clinical Cardiac Electrophysiology Physician US NPIs
97.7188/100 MIPS final score — 14.6 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Clinical Cardiac Electrophysiology Physician. Quality dim: 75.4375.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
GAURAV UPADHYAY appears in the CMS NPPES registry as a Clinical Cardiac Electrophysiology Physician provider at 5841 S MARYLAND AVE, CHICAGO, IL, 60637, with a listed phone of (888) 824-0200. NPI 1306973748 was issued on 02/27/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what UPADHYAY most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 638 prescription claims written by this provider, covering 182 Medicare beneficiaries and totaling roughly $151K in drug spend, split 21% brand-name and 79% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97.7188/100 for the 2023 performance year (Quality 75.4375), compared with the national average of 83.1.
Clinical Cardiac Electrophysiology Physician is a narrow specialty nationwide, with 1,570 enrolled providers across 52 states and an average of 1,596 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1306973748 |
|---|---|
| Specialty | Clinical Cardiac Electrophysiology Physician |
| Gender | Male |
| NPI Issued | 02/27/2007 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm GAURAV UPADHYAY's current license status, disciplinary history, and board certifications with the Illinois Department of Financial and Professional Regulation in Illinois before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where GAURAV UPADHYAY bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) — CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for GAURAV UPADHYAY. Source: openpaymentsdata.cms.gov.
Total received
$103.2K
Largest payer
BIOTRONIK INC.
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
License & disciplinary context — Illinois IDFPR 2023 annual report
Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~42K Illinois medical licensees in 2023 — they are NOT specific to GAURAV UPADHYAY. To verify GAURAV UPADHYAY's current license status, search the IDFPR public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
IDFPR publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Illinois disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Typical
21% brand-name claims vs 79% generic, on 638 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 1,531
- Total Day Supply
- 45,634
- Brand vs Generic
- 21% brand / 79% generic
- Brand Drug Cost
- $127K
- Generic Drug Cost
- $24K
Patient Demographics
- Average Patient Age
- 74.6 years
- Avg HCC Risk Score
- 1.66
- Gender Split
- 55% female / 45% male
- Age Distribution
- <65: 18, 65-74: 68, 75-84: 76, 85+: 20
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What GAURAV UPADHYAY prescribes most
Top Medicare Part D drugs by claim count, 2023
- Metoprolol Succinate
Metoprolol Succinate
239 claims
- Eliquis 56
Eliquis
56 claims
- Xarelto 49
Xarelto
49 claims
- Carvedilol 41
Carvedilol
41 claims
- Flecainide Acetate 29
Flecainide Acetate
29 claims
- Dofetilide 22
Dofetilide
22 claims
- Entresto 22
Entresto
22 claims
- Amiodarone Hcl 20
Amiodarone Hcl
20 claims
| Drug | Claims |
|---|---|
| Metoprolol Succinate | 239 |
| Eliquis Apixaban | 56 |
| Xarelto Rivaroxaban | 49 |
| Carvedilol | 41 |
| Flecainide Acetate | 29 |
| Dofetilide | 22 |
| Entresto Sacubitril/Valsartan | 22 |
| Amiodarone Hcl | 20 |
| Furosemide | 16 |
| Metoprolol Tartrate | 15 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Clinical Cardiac Electrophysiology Physician Overview
How GAURAV UPADHYAY fits within the Clinical Cardiac Electrophysiology Physician landscape nationally.
GAURAV UPADHYAY's 638 claims are below the specialty average of 1,596.
Nearby Clinical Cardiac Electrophysiology Physician Providers in Illinois
Other clinicians with the same primary specialty enrolled in Illinois, drawn from the same CMS NPPES roster as UPADHYAY.
Compare Clinical Cardiac Electrophysiology Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
What is GAURAV UPADHYAY's specialty? ▼
How much does GAURAV UPADHYAY prescribe under Medicare Part D? ▼
What is GAURAV UPADHYAY's Medicare quality score? ▼
Where is GAURAV UPADHYAY located? ▼
What is GAURAV UPADHYAY's NPI number? ▼
Does GAURAV UPADHYAY prescribe more brand-name or generic drugs? ▼
How many Clinical Cardiac Electrophysiology Physician providers are there in the US? ▼
What drugs does GAURAV UPADHYAY prescribe most often? ▼
Does GAURAV UPADHYAY accept Medicare? ▼
How can I verify GAURAV UPADHYAY's credentials? ▼
Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology