Individual provider Active NPI

Udayashankar K Setru, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1245287689
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
204478 Issued in NY
Practice address
57 E Mount Eden Ave
Bronx, NY 10452-5806
Phone
(718) 716-8381
Fax
(718) 716-0054
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 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 204478 NY Primary

Addresses

Primary practice location

57 E Mount Eden Ave
Bronx, NY 10452-5806

Mailing address

17 Beckett Close
Irvington, NY 10533-2413
Phone (718) 716-8381

Other identifiers 1

IdentifierTypeStateIssuer
01688559MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100309000329 NY Practitioner - Internal Medicine 9032254537 Practice locations: Bronx, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204478NYMDInternal Medicine Physician

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1245287689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BECKETT CLOSE",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105332413",
            "telephone_number": "718-716-8381",
            "fax_number": "718-716-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 E MOUNT EDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104525806",
            "telephone_number": "718-716-8381",
            "fax_number": "718-716-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETRU",
        "first_name": "UDAYASHANKAR",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "204478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01688559",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.