NPIMap

Individual provider Active NPI

Michelle S Udeshi, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1023140902
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
230929 Issued in MA
Practice address
133 Brookline Ave
Boston, MA 02215-3904
Phone
(617) 421-3100
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 230929 MA Primary

Addresses

Primary practice location

133 Brookline Ave
Boston, MA 02215-3904

Mailing address

133 Brookline Ave
Boston, MA 02215-3904

Other identifiers 1

IdentifierTypeStateIssuer
03437872MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20260128002766 FL Practitioner - Diagnostic Radiology 2961501614 Reassigns benefits to 1 organization
I20260219001804 OK Practitioner - Diagnostic Radiology 2961501614 Reassigns benefits to 1 organization
I20260219002515 TX Practitioner - Diagnostic Radiology 2961501614 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians
Cherokee NationGroup PAC ID 5799698742, 446 clinicians
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians
Clinton Indian Health CenterGroup PAC ID 2163324237, 74 clinicians
Diagnostic Imaging Associates IncGroup PAC ID 8820083645, 88 clinicians
Pawnee Indian Health CenterGroup PAC ID 2769470160, 88 clinicians
Lawton Indian HospitalGroup PAC ID 6406800234, 126 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

1001 S 41St St E
Three Rivers Health Center
Muskogee, OK 74403-6253
Phone (918) 687-0201

101 S Moore Ave
Claremore, OK 74017-5047
Phone (539) 234-1000

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

10321 N 2274 Rd
Clinton, OK 73601-7521
Phone (580) 331-3410

109 Crimson Isles Dr
Jupiter, FL 33478-5485
Phone (918) 935-3550

1127 S George Nigh Expy
Choctaw Nation Health Care McAlester
McAlester, OK 74501-7143
Phone (539) 316-6391

1201 Heritage Cir
Pawnee, OK 74058-3744
Phone (918) 762-2517

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5000

1800 E Coplin St
Okemah, OK 74859-4642
Phone (918) 623-1424

1801 Chukka Hina
Durant, OK 74701-7117
Phone (539) 316-6391

27371 S 4410 Rd
Vinita, OK 74301-7953
Phone (918) 256-4800

301 S J T Stites St
Sallisaw, OK 74955-9302
Phone (918) 775-9150

900 N Owen Walters Boulevard
A Mo Health Center
Salina, OK 74365-5003
Phone (918) 434-8500

902 Lincoln Rd
Choctaw National Health Care Idabel
Idabel, OK 74745-7817
Phone (539) 316-6391

One Choctaw Way
Talihina, OK 74571-2022

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
230929MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Associates Inc Diagnostic Radiology CurrentSince Dec 21, 2025 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 1, 2026 Accepting new patients
El Reno Indian Health Center CurrentSince Feb 4, 2026 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Feb 1, 2026 Accepting new patients
Anadarko Indian Health Center CurrentSince Feb 4, 2026 Accepting new patients
Clinton Indian Health Center CurrentSince Feb 4, 2026 Accepting new patients
Lawton Indian Hospital CurrentSince Feb 4, 2026 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Feb 1, 2026 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 1, 2026 Accepting new patients
Watonga Indian Health Center CurrentSince Feb 4, 2026 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

201 E Parker McKenzie Dr
Anadarko, OK 73005
Phone (405) 247-7900

10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300

1801 Parkview Dr
El Reno, OK 73036
Phone (405) 234-5600

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

1201 Heritage Cir
Pawnee, OK 74058
Phone (918) 762-2517

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

1305 S Clarence Nash Blvd
Watonga, OK 73772
Phone (580) 623-4991

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 17

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1023140902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDESHI",
        "first_name": "MICHELLE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "230929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03437872",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.