Individual provider Active NPI

Laurence C Udoff, MD

  • Reproductive Endocrinology Physician
  • Fairfax, VA
National Provider Identifier
1497789853
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
D46191 Issued in MD
Practice address
3015 Williams Dr
#202
Fairfax, VA 22031-4623
Phone
(703) 289-1963
Fax
(703) 698-3977
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X D46191 MD Primary
Obstetrics & Gynecology Physician 207V00000X D46191 MD

Addresses

Primary practice location

3015 Williams Dr
#202
Fairfax, VA 22031-4623

Mailing address

3015 Williams Dr
#202
Fairfax, VA 22031-4623
Phone (703) 289-1963

Other identifiers 1

IdentifierTypeStateIssuer
150951900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D46191MDMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
University of MD Obstetrical and Gynecological Asso. PA Obstetrics & Gynecology PastSince Jan 21, 2024 Accepting new patients
Givff LLC Reproductive Endocrinology PastSince Nov 3, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: laurence.udoffmd.p2@direct.msmg.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1497789853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 WILLIAMS DR",
            "address_2": "#202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314623",
            "telephone_number": "703-289-1963",
            "fax_number": "703-698-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 WILLIAMS DR",
            "address_2": "#202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314623",
            "telephone_number": "703-289-1963",
            "fax_number": "703-698-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOFF",
        "first_name": "LAURENCE",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MD",
            "license": "D46191",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D46191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150951900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.