Individual provider Active NPI

Kelechi A Uduhiri, MD

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1598880460
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0066253 Issued in MD
Practice address
1040 Park Ave Ste 200
Baltimore, MD 21201-5634
Phone
(443) 738-0300
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0066253 MD Primary
Family Medicine Physician 207Q00000X MD037787 DC

Addresses

Primary practice location

1040 Park Ave Ste 200
Baltimore, MD 21201-5634

Mailing address

1040 Park Ave Ste 200
Baltimore, MD 21201-5634
Phone (443) 738-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20100419000339 MD Practitioner - Family PracticePractitioner - Preventive Medicine 7911034228 Reassigns benefits to 1 organization
I20111230000157 DC Practitioner - Family Practice 7911034228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland General Clinical Practice Group, Inc. CurrentSince Aug 12, 2020 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 1, 2024 Accepting new patients
Maryland General Clinical Practice Group, Inc. CurrentSince Aug 12, 2020 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4910 Massachusetts Ave NW
Ste 115
Washington, DC 20016
Phone (202) 237-0015

3007 Tilden St NW
Ste 5N
Washington, DC 20008

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

4151 Bladensburg Rd
Colmar Manor, MD 20722
Phone (301) 699-7700

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1598880460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015634",
            "telephone_number": "443-738-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015634",
            "telephone_number": "443-738-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDUHIRI",
        "first_name": "KELECHI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0066253",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD037787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.