Uthra Kodiyalam, M.D.,

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA066933 Issued in NJ

Practice address

55 Morris Ave
Suite 300
Springfield, NJ 07081-1426

Phone

(973) 379-9601

Fax

(973) 467-6779

NPI assigned

Apr 5, 2006

Sex

Female

Sole proprietor

No

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ukodiyalam77283@direct.optum.com

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.

• Optum Medical Care of New Jersey PC

  • Pediatrics Physician
  • New Hyde Park, NY
  • NPI 1578665048

  Internal Medicine, NJ

  Medicare reassignment Care Compare group NPD
• Optum Medical Care of New Jersey PC

  • Durable Medical Equipment & Medical Supplies
  • Toms River, NJ
  • NPI 1477273480
  Care Compare group
• Optum Medical Care of New Jersey PC

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD
• Riverside Medical Group

  • Nurse Practitioner
  • Secaucus, NJ
  • NPI 1053867598
  NPD (past)

Specialty

Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Care of New Jersey PC 168 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.15 of 100Reported as group

Quality

71.59

Promoting interoperability

100

Improvement activities

40

Cost

76.65

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1770545501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PRINCETON DR",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741219",
            "telephone_number": "908-286-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MORRIS AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811426",
            "telephone_number": "973-379-9601",
            "fax_number": "973-467-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODIYALAM",
        "first_name": "UTHRA",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA066933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MA066933",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Bernard Kerner, M.D.
• Ashish Abhay Khot, MD
• Kidney Wellness Nutrition LLC
• DO Yoon Kim, MD, DDS
• Karen J. M. King, FNP-BC
• Michael Adam Koffman, PH.D.
• Sheryl Kolat, MA, CCC-SLP
• Cheuk Hiu Kong
• Sharon Konigsberg, DMD
• Yelena N Korkmazsky, MD

• All providers in Springfield, NJ
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.