Jerry Ainene Uduevbo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

249063 Issued in NY

Practice address

2503 Church Ave
Brooklyn, NY 11226-4060

Phone

(718) 928-7575

NPI assigned

May 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Internal Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Jerry Uduevbo, M.D., P.C.

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1033436365
  Medicare reassignment NPD Authorized official
• Fort Edward Rescue Squad Inc

  • Ambulance
  • Fort Edward, NY
  • NPI 1427031319
  NPD (past)
• Atlantic Professional Services of Rhode Island Incorporated

  • Hospitalist Physician
  • Wakefield, RI
  • NPI 1922036946
  NPD (past)
• Baptist Physician Associates LLC

  • Urgent Care Clinic/Center
  • Navarre, FL
  • NPI 1235128646
  NPD (past)

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325289600000",
    "number": "1740448208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264060",
            "telephone_number": "718-928-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264060",
            "telephone_number": "718-928-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDUEVBO",
        "first_name": "JERRY",
        "middle_name": "AINENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2011-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "13999",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "249063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Galina Udod, MD
• Daniel Chukude Udoji, M.D
• Chukwuebuka Udokwu, MD
• Edidiong Udoyen, MD
• Diana Udrea
• Chinwe Constance Uduhiri, RN
• Janice Uduma Sanwo, DO
• Sanika Udyaver, MD
• Amber Nicole Ufford, PH.D.
• Kiryl Ufimtsau, MD

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2011; 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.