Individual provider Active NPI

Sudeep Yadav, MD

  • Student in an Organized Health Care Education/Training Program
  • Wellington, FL
National Provider Identifier
1417643958
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone
(561) 472-2583
NPI assigned
Apr 17, 2023
Last updated
Apr 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL Primary

Addresses

Primary practice location

10101 Forest Hill Blvd
Wellington, FL 33414-6103

Mailing address

5035 S East End Ave Apt 2107S
Chicago, IL 60615-0053
Phone (131) 296-1057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240206000873 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3375986466

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 Hot Meal St
Pittsburgh, PA 15203-2348

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1417643958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 S EAST END AVE APT 2107S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606150053",
            "telephone_number": "131-296-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146103",
            "telephone_number": "561-472-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAV",
        "first_name": "SUDEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.