Individual provider Active NPI

Sandeepa Makarand Utpat, MD

  • Internal Medicine Physician
  • Lakewood, NJ
National Provider Identifier
1205864899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233554 Issued in NY
Practice address
101 Prospect St
Suite 115
Lakewood, NJ 08701-5020
Phone
(732) 905-6635
Fax
(732) 905-6643
NPI assigned
Jun 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233554 NY Primary

Addresses

Primary practice location

101 Prospect St
Suite 115
Lakewood, NJ 08701-5020

Mailing address

101 Prospect St
Suite 115
Lakewood, NJ 08701-5020
Phone (732) 905-6635

Other identifiers 1

IdentifierTypeStateIssuer
02623687MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070105000088 NJ Practitioner - Infectious DiseasePractitioner - Internal Medicine 4284685249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Diseases Professionals LLCGroup PAC ID 1355341546, 3 clinicians

Practice addresses (Care Compare)

9 Hospital Dr
Suite B4
Toms River, NJ 08755-6425
Phone (732) 905-6635

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.22 of 100Reported as group
Quality
59.41
Improvement activities
40
Cost
68.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233554NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Diseases Professionals LLC CurrentSince Jul 1, 2006 Accepting new patients
Cardiology Associates of Ocean County Past Accepting new patients
Nymhc FPP Nephrology Past Accepting new patients

Locations

101 Prospect St
Ste 115
Lakewood, NJ 08701
Phone (732) 364-1014

9 Hospital Dr
Ste B4
Toms River, NJ 08755
Phone (732) 766-3357

9 Hospital Dr
Ste B8
Toms River, NJ 08755
Phone (732) 349-8899

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205864899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 115",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015020",
            "telephone_number": "732-905-6635",
            "fax_number": "732-905-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 115",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015020",
            "telephone_number": "732-905-6635",
            "fax_number": "732-905-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTPAT",
        "first_name": "SANDEEPA",
        "middle_name": "MAKARAND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "233554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02623687",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.