Active NPI
Jacob Allan Udell, MD, MPH
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1013194141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 234457
- Practice address
- 75 Francis St
Brigham & Women'S Hospital, Cardiology
Boston, MA 02115-6110 - Phone
- (416) 315-6844
- NPI assigned
- Jan 31, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 234457 | MA | Primary |
Addresses
Primary practice location
75 Francis St
Brigham & Women'S Hospital, Cardiology
Boston, MA 02115-6110
Mailing address
717-1009 Bay Street
Toronto, ONTARIO M5G2J9
CA
Phone (416) 315-6844
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234457 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1013194141",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "717-1009 BAY STREET",
"city": "TORONTO",
"state": "ONTARIO",
"postal_code": "M5G2J9",
"telephone_number": "416-315-6844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"address_2": "BRIGHAM & WOMEN'S HOSPITAL, CARDIOLOGY",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110",
"telephone_number": "416-315-6844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDELL",
"first_name": "JACOB",
"middle_name": "ALLAN",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-31",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "234457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.