Ededet Akpan Udo, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

202225 Issued in NY

Practice address

2597 Frederick Douglass Blvd
New York, NY 10030-2105

Phone

(212) 234-3433

Fax

(212) 234-1197

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ICEHCA/Endpoint/ICEHCA

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.

• Ededet Akpan Udo, MD, PC

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1073726907
  Medicare reassignment NPD Authorized official
• St Lukes Roosevelt Hospital Center

  • General Acute Care Hospital
  • New York, NY
  • NPI 1104982917
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1457466864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2597 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302105",
            "telephone_number": "212-234-3433",
            "fax_number": "212-234-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2597 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302105",
            "telephone_number": "212-234-3433",
            "fax_number": "212-234-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDO",
        "first_name": "EDEDET",
        "middle_name": "AKPAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "202225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02075510",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Udeji
• Robert A Udesky, MD
• Ehizode Martin Udevbulu, MD
• Robert Udewitz, PH.D.
• Zachary Branton Udko, LMHC
• Andrea Lynn Udoff, PH.D.
• Anthony James Udofia
• Mercy Adaobi Udoji, MD
• Michael Udolf, MSED
• Sasha-Noelle Udom

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.