Active NPI
Udayashankar K Setru, M.D.
- Internal Medicine Physician
- Bronx, NY
National Provider Identifier
1245287689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 204478
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01688559 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 204478 | NY | MD | Internal 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.