Jeremy Udkoff

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MD478556 Issued in PA

Practice address

607 Washington Rd Lowr Level
Mt Lebanon, PA 15228-1903

Phone

(412) 563-0217

NPI assigned

Mar 30, 2018

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, OH2 enrollments

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 2

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anders Dermatology IncorporatedGroup PAC ID 2163404294, 10 clinicians

Dermeve PCGroup PAC ID 0042751562, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00419
• Direct secure messaging: jeremyudkoffmd@mtlda.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermeve PC

  dba Mt. Lebanon Dermatology Associates

  • MOHS-Micrographic Surgery Physician
  • Mt Lebanon, PA
  • NPI 1356111645

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Anders Dermatology Incorporated

  • Dermatology Physician
  • Toledo, OH
  • NPI 1215968896
  Medicare reassignment Care Compare group NPD
• Pennsylvania Centre for Dermatology, LLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1861501801
  Medicare reassignment NPD

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1447756499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON RD LOWR LEVEL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON RD LOWR LEVEL",
            "city": "MT LEBANON",
            "state": "PA",
            "postal_code": "152281903",
            "telephone_number": "412-563-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDKOFF",
        "first_name": "JEREMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-30",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "323142",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "323142",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "PA",
            "license": "MD478556",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD478556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Reid Salsbury, LCSW
• Maria Smith, CCTS,CGLC
• Ryan Smith, BA,CSMS,CNLP,CHHP
• Sonder Wellness Corporation (Cassy Sanderson)
• Stonehendge Inc. (The Eye Gallery of Mt. Lebanon)
• Wendy Weaver-Graham, PH.D
• Nicolene Mary Zapach, M.A.
• Nikolai Sava Zdrale, M.D.

• MOHS-Micrographic Surgery Physician in Mt Lebanon, PA
• Providers in Mt Lebanon, PA by specialty
• MOHS-Micrographic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.