NPIMap

Individual provider Active NPI

Iliya Udler, D.O.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1447662861
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25169 Issued in MS
Practice address
1850 Chadwick Dr
Jackson, MS 39204-3404
Phone
(601) 376-2832
Fax
(601) 936-1260
NPI assigned
May 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3815 TN
Hospitalist Physician 208M00000X 25169 MS
Internal Medicine Physician 207R00000X 25169 MS Primary

Addresses

Primary practice location

1850 Chadwick Dr
Jackson, MS 39204-3404

Mailing address

734B Sherwood Dr
Jackson, MS 39216-3303

Other practice location 1

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

Other identifiers 1

IdentifierTypeStateIssuer
04580733MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN, VI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20171028000016 MS Practitioner - Internal Medicine 4789962283 Reassigns benefits to 3 organizations
Practice locations: Jackson, MS
I20210420001754 TN Practitioner - Internal Medicine 4789962283 Reassigns benefits to 4 organizations
I20220122000012 VI Practitioner - Internal Medicine 4789962283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CH MSSP Services TN PLLCGroup PAC ID 0042603656, 48 clinicians
Impact Physician Group, Tennessee LLCGroup PAC ID 3476051525, 10 clinicians
Impact Physician Group LLCGroup PAC ID 6204199086, 26 clinicians
Mississippi Hma Hospitalists LLCGroup PAC ID 5991972077, 55 clinicians
Greenbrook Physician Services, LLCGroup PAC ID 5597267427, 70 clinicians

Practice addresses (Care Compare)

Memphis, TN 38103
Phone (337) 991-9276

1240 S Germantown Rd
Germantown, TN 38138-2226
Phone (901) 275-3300

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-8206

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.53 of 100Reported as group
Quality
69.43
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalists of Ms, LLC Hospitalist CurrentSince Sep 15, 2021 Accepting new patients
Impact Physician Group, LLC Internal Medicine CurrentSince May 13, 2025 Accepting new patients
Mississippi Hma Hospitalists, LLC Hospitalist CurrentSince Sep 12, 2017 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Dec 19, 2021 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Hospitalist CurrentSince Sep 15, 2021 Accepting new patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Mar 1, 2021 Accepting new patients
Mississippi Hma Hospitalists, LLC Hospitalist CurrentSince Sep 12, 2017 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Greenbrook Physician Services, LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Dec 19, 2021 Accepting new patients
Peter J Jensen MD PC Past Accepting new patients
Jackson Hma LLC Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 8

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1447662861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734B SHERWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392163303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "601-376-2832",
            "fax_number": "601-936-1260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7691 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383904",
            "country_code": "US",
            "telephone_number": "901-516-1290",
            "fax_number": "901-516-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDLER",
        "first_name": "ILIYA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "3815",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "25169",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "25169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04580733",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.