Sukruti Vishal Udeshi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1243779 Issued in CA

Practice address

101 Rowland Way Ste 200
Novato, CA 94945-5056

Phone

(415) 878-7200

NPI assigned

Jun 20, 2018

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Family Practice

Education

Virginia Commonwealth University, School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Novato, CA, CCN 057031
• Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
• Novato Community Hospital Hospital, Novato, CA, CCN 050131
• Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
• Sonoma Valley Hospital Hospital, Sonoma, CA, CCN 050090
• California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sudeshi174328@soc.inova.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Orinda, CA
  • NPI 1366898538

  Family Medicine

  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Novato, CA
  • NPI 1104059153
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)
• Inova Physician Partners, Inc. - Specialists

  • Orthopaedic Surgery Physician
  • Leesburg, VA
  • NPI 1811204050
  NPD (past)

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

• Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
  • NPI 1396725677
  Care Compare affiliation
• Sonoma Valley Health Care District

  • General Acute Care Hospital
  • Sonoma, CA
  • NPI 1710063870
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Novato, CA
  • NPI 1104059153
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1740348929
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1205865870
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Novato, CA
  • NPI 1265461024
  Care Compare affiliation

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1821582149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "415-878-7200",
            "fax_number": "415-369-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ROWLAND WAY STE 200",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455056",
            "telephone_number": "415-878-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1383 N McDowell Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949547118",
            "country_code": "US",
            "telephone_number": "707-308-2840",
            "fax_number": "707-573-5376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5300 Snyder Ln",
            "address_purpose": "LOCATION",
            "city": "Rohnert Park",
            "state": "CA",
            "postal_code": "949282915",
            "country_code": "US",
            "telephone_number": "707-585-8347",
            "fax_number": "707-573-5424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDESHI",
        "first_name": "SUKRUTI",
        "middle_name": "VISHAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "1243779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A174028",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sudeshi174328@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3650 Joseph Siewick Dr Ste 400",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220331715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Tung, DDS, MS
• Mallory Turnbull, MA, CCC-SLP
• Eric Royall Tyler, D.D.S.
• Martin Uche
• UCSF Children'S Hospital
• Adaeze Udezue, M.D
• Nushrat Ullah, M.D.
• Jennifer Ullman, OTR/L
• Byron Urdaneta
• US Vet Meds, LLC

• Family Medicine Physician in Novato, CA
• Providers in Novato, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.