NPIMap

Individual provider Active NPI

Navalkishor R Udgiri, MD

  • Vascular Surgery Physician
  • Erie, PA
National Provider Identifier
1275700585
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD446129 Issued in PA
Practice address
2315 Myrtle St Ste 120
Erie, PA 16502-4602
Phone
(814) 456-9197
Fax
(814) 455-2765
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD446129 PA Primary

Addresses

Primary practice location

2315 Myrtle St Ste 120
Erie, PA 16502-4602

Mailing address

2315 Myrtle St Ste 120
Erie, PA 16502-4602
Phone (814) 456-9197

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nudgiri21649@direct.ahn.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140807000903 PA Practitioner - Vascular Surgery 2769609213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2315 Myrtle St
Suite 160
Erie, PA 16502-4602
Phone (814) 456-9197

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)19
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD446129PAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc CurrentSince Jul 14, 2014 Accepting new patients
Saint Vincent Medical Education and Research Institute Past Accepting new patients
Saint Vincent Health Center Past Accepting new patients
Saint Vincent Consultants in Cardiovascular Diseases PastSince Oct 4, 2020 Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

2315 Myrtle St
Ste 160
Erie, PA 16502
Phone (814) 456-9197

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

2315 Myrtle St
Ste 120
Erie, PA 16502
Phone (814) 456-9197

Interoperability endpoints

  • Direct secure messaging: nudgiri21649@direct.ahn.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1275700585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 120",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024602",
            "telephone_number": "814-456-9197",
            "fax_number": "814-455-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 120",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024602",
            "telephone_number": "814-456-9197",
            "fax_number": "814-455-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDGIRI",
        "first_name": "NAVALKISHOR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD446129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nudgiri21649@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2315 Myrtle St Ste 120",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165024602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.