NPI registry status
Active
2026 NPPES data Internal Medicine Physician NPI 1447633805 MD, MPH
Verify on CMS → Gautham Upadhya, MD, MPH
Internal Medicine Physician in Staten Island, New York.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 172,858 in Internal Medicine Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
36
Medicare Part D claims · 20 beneficiaries · Internal Medicine Physician avg: 3K
MIPS score
66.8/100
▼ 16 pts below national avg 83.1 · Mid-tier
Industry payments
$719.81
27 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Gautham Upadhya, MD, MPH reported a CMS MIPS final score of 66.8/100 - below the 83.1 national average - and filed 36 Medicare Part D claims in 2023.
- 66.8/100
- MIPS score · -16 vs avg
- 36
- Part D claims, 2023
- 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.
Gautham Upadhya, MD, MPH's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
67 7th percentile higher than 7% 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
Where Gautham Upadhya, MD, MPH sits
This provider among internal medicine physician peers
Across the 36,260 internal medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Gautham Upadhya, MD, MPH writes more Part D claims than 5% of them and scores higher on MIPS quality than 7% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one internal medicine physician peer from a representative sample of 60; the gold marker is Gautham Upadhya, MD, MPH. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Gautham Upadhya, MD, MPH 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 Gautham Upadhya, MD, MPH?
Below national averagePrimary specialty
Internal Medicine Physician
Medicare Part D claims
36 99% vs specialty avg
MIPS final score
66.8/100 16.3 pts vs avg
Specialty distribution in New York
How Internal Medicine Physician compares to other specialties among New York providers
Medicare quality performance, MIPS
Gautham Upadhya, MD, MPH's 2023 MIPS final score plotted against the Internal Medicine Physician national average
- MIPS Final Score
- 66.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Internal Medicine Physician) - 66.8/100 vs national avg 83.1
How MIPS and board certification work
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).
Gautham Upadhya, MD, MPH appears in the CMS NPPES registry as a Internal Medicine Physician provider holding MD, MPH credentials at 1161 VICTORY BLVD, Staten Island, NY, 10301, with a listed phone of (718) 818-7425. NPI 1447633805 was issued on 07/02/2015.
Medicare Part D records for calendar year 2023 show 36 prescription claims written by this provider, covering 20 Medicare beneficiaries and totaling roughly $8K in drug spend. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 66.8/100 for the 2023 performance year (Quality 83.3), compared with the national average of 83.1.
Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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 | 1447633805 |
|---|---|
| Specialty | Internal Medicine Physician |
| Credentials | MD, MPH |
| Gender | Male |
| NPI Issued | 07/02/2015 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
66.8053
Final Score
Avg: 83.1
83.2772
Quality
0.5556
Promoting Interoperability
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Gautham Upadhya, MD, MPH 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.
Advantagecare Physicians PC
Staten Island, NY
Amboy Medical Practice PC
Staten Island, NY
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 Gautham Upadhya, MD, MPH. Source: openpaymentsdata.cms.gov.
Total received
$720
Largest payer
Janssen Pharmaceuticals, 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 - New York NYSBPMC 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 ~100K New York medical licensees in 2023 - they are NOT specific to Gautham Upadhya, MD, MPH. To verify Gautham Upadhya, MD, MPH's current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases
NYSBPMC 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 New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
36
Total Claims
$8K
Total Drug Cost
20
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 80
- Total Day Supply
- 2,336
- Generic Drug Cost
- $387
Patient Demographics
- Average Patient Age
- 71.1 years
- Avg HCC Risk Score
- 1.14
Internal Medicine Physician Overview
How Gautham Upadhya, MD, MPH fits within the Internal Medicine Physician landscape nationally.
172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider
Gautham Upadhya, MD, MPH's 36 claims are below the specialty average of 2,716.
Nearby Internal Medicine Physician Providers in New York
Other clinicians with the same primary specialty enrolled in New York, drawn from the same CMS NPPES roster as Upadhya.
Dr. Deborah Aanonsen
D.O.
Staten Island, NY
Dr. Nivedita Aanur
M.D.
New York, NY
Dr. Jay Aaron
MD
Great Neck, NY
Dr. Justin Aaron
MD
New York, NY
Ahmad Abadi
Poughkeepsie, NY
Compare Internal Medicine Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the New York medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Internal Medicine Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
What is Gautham Upadhya, MD, MPH's specialty? ▼
Gautham Upadhya, MD, MPH specializes in Internal Medicine Physician and practices in Staten Island, New York. Credentials: MD, MPH.
How much does Gautham Upadhya, MD, MPH prescribe under Medicare Part D? ▼
In 2023, Gautham Upadhya, MD, MPH wrote 36 Medicare Part D claims totaling $8K in drug costs for 20 beneficiaries.
What is Gautham Upadhya, MD, MPH's Medicare quality score? ▼
Gautham Upadhya, MD, MPH has a CMS MIPS Final Score of 66.8/100 (Quality: 83.3). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Gautham Upadhya, MD, MPH located? ▼
Gautham Upadhya, MD, MPH is located at 1161 VICTORY BLVD, Staten Island, NY, 10301. Phone: (718) 818-7425.
What is Gautham Upadhya, MD, MPH's NPI number? ▼
Gautham Upadhya, MD, MPH's National Provider Identifier (NPI) is 1447633805, issued on 07/02/2015.
How many Internal Medicine Physician providers are there in the US? ▼
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
Does Gautham Upadhya, MD, MPH accept Medicare? ▼
Gautham Upadhya, MD, MPH appears in CMS Medicare data with 36 Part D claims and 20 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Gautham Upadhya, MD, MPH's credentials? ▼
Gautham Upadhya, MD, MPH's NPI is 1447633805 with credentials MD, MPH. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.
Data Sources
View source datasets and methodology notes
- 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
Compiled from official public sources by the PlainDoctor editorial team.