Samuel Udell, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00157100 Issued in NJ

Practice address

5635 Westfield Ave
Pennsauken, NJ 08110-1853

Phone

(856) 662-8999

Fax

(856) 662-8855

NPI assigned

May 22, 2006

Last updated

Jan 23, 2012By the provider in NPPES

Sex

Male

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Healthdrive Podiatry Group, PC

  dba HealthDrive Podiatry Group

  • Podiatrist
  • Princeton, NJ
  • NPI 1013106533
  Medicare reassignment NPD
• Samuel Udell

  • Durable Medical Equipment & Medical Supplies
  • Pennsauken, NJ
  • NPI 1194806356
  NPD (past) Authorized official
• Healthdrive Podiatry Group, PC

  dba HealthDrive Podiatry Group

  • Podiatrist
  • Dublin, OH
  • NPI 1689613598
  NPD

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1841244837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 WESTFIELD AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081101853",
            "telephone_number": "856-662-8999",
            "fax_number": "856-662-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 WESTFIELD AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081101853",
            "telephone_number": "856-662-8999",
            "fax_number": "856-662-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDELL",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00157100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2343801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Township of Pennsauken
• Christine Faith Tracy
• Aditi Trivedi, MD
• Talaura Truluck
• Tyler Dialysis LLC (South Jersey Dialysis)
• Union Association of the Children's Home of Burlington County, Inc.
• Unity Care Service DDD LLC
• Denisha Vanburen, LPC
• Vayana Organics LLC (Vayana Organics)
• Venezia Marie Vega

• Podiatrist in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.