Individual provider Active NPI

Nkechinyere Udenyi, MD

  • Family Medicine Physician
  • Cedar Park, TX
National Provider Identifier
1073684783
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T0144 Issued in TX
Practice address
3240 E Whitestone Blvd Unit 48
Cedar Park, TX 78613-1910
Phone
(510) 334-4171
Fax
(859) 757-0312
NPI assigned
Nov 13, 2006
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X T0144 TX
Geriatric Medicine (Family Medicine) Physician 207QG0300X 0101267577 VA
Family Medicine Physician 207Q00000X T0144 TX Primary

Addresses

Primary practice location

3240 E Whitestone Blvd Unit 48
Cedar Park, TX 78613-1910

Mailing address

500 E Whitestone Blvd Unit 3693
Cedar Park, TX 78630-4450
Phone (510) 334-4171

Other identifiers 1

IdentifierTypeStateIssuer
T0144OtherTXTEXAS MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811002495 TX Practitioner - Family PracticePractitioner - Geriatric Medicine 5799887097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 C-Bar Ranch TRL
Unit 89
Cedar Park, TX 78613-2687
Phone (510) 334-4171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T0144TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health Medical Group LLC CurrentSince Aug 1, 2022 Accepting new patients
Shalom GP Medical Group LLC Family Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

9903 Hunters Pond
San Antonio, TX 78224
Phone (210) 477-2200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/CDAADD/Endpoint/CDAADD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1073684783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E WHITESTONE BLVD UNIT 3693",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786304450",
            "telephone_number": "510-334-4171",
            "fax_number": "859-757-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 E WHITESTONE BLVD UNIT 48",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786131910",
            "telephone_number": "510-334-4171",
            "fax_number": "859-757-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDENYI",
        "first_name": "NKECHINYERE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "T0144",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101267577",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T0144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "T0144",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.