Shruti Balwalli-Udyawer, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00769400 Issued in NJ

Practice address

149 Main St
South River, NJ 08882-1232

Phone

(732) 238-6440

Fax

(732) 651-1232

NPI assigned

Jan 22, 2018

Last updated

Feb 24, 2020By the provider in NPPES

Sex

Female

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 NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039
• JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Merit-based Incentive Payment System (MIPS)

Final score

81.33 of 100Reported as group

Quality

66.38

Promoting interoperability

100

Improvement activities

40

Cost

71.39

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
• FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
• Direct secure messaging: shruti.balwalli-udyawer@direct.hackensackmeridian.org

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMHMG Specialty Care

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment Care Compare group NPD
• Hackensack Meridian Health Medical Group - Primary Care PC

  dba HMHMG Primary Care

  • Family Medicine Physician
  • Red Bank, NJ
  • NPI 1336203538
  Medicare reassignment NPD
• Hackensack Meridian Urgent Care Plus PC

  • Urgent Care Clinic/Center
  • Hoboken, NJ
  • NPI 1396858874
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMMG New Jersey Oral & Maxillofacial Surgery

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Complex Care PC

  dba HMHMG Complex Care

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626
  NPD (past)
• Meridian Medical Group - Specialty Care, PC

  dba Hackensack Meridian Medical Group - One Medical PC

  • Family Medicine Physician
  • Edgewater, NJ
  • NPI 1275362105
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  dba JFK University Medical Center

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Raritan Bay Medical Center-Old Bridge

  • General Acute Care Hospital
  • Old Bridge, NJ
  • NPI 1356828172
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  dba Raritan Bay Medical Center

  • General Acute Care Hospital
  • Perth Amboy, NJ
  • NPI 1790297455
  Care Compare affiliation

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1689182867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203967",
            "telephone_number": "732-452-9700",
            "fax_number": "732-452-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 MAIN ST",
            "city": "SOUTH RIVER",
            "state": "NJ",
            "postal_code": "088821232",
            "telephone_number": "732-238-6440",
            "fax_number": "732-651-1232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 James St",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088203967",
            "country_code": "US",
            "telephone_number": "732-452-9700",
            "fax_number": "732-452-9720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALWALLI-UDYAWER",
        "first_name": "SHRUTI",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00769400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "26NJ00769400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in South River, NJ
• Providers in South River, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.