NPIMap

Organization Active NPI

Bronx Lebanon Nephrology, PLLC

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1851455885
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
255628 Issued in NY
Legal business name
BRONX LEBANON NEPHROLOGY, PLLC
Practice address
1650 Selwyn Ave
8-G
Bronx, NY 10457-7626
Phone
(718) 518-5232
Fax
(718) 518-5636
NPI assigned
Dec 21, 2006
Reactivated
May 1, 2012
Last updated
May 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Authorized official

Name
Kalpana Uday, MDNPI 1043263882
Title
Manager/Partner
Phone
(718) 518-5232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 255628 NY Primary

Addresses

Primary practice location

1650 Selwyn Ave
8-G
Bronx, NY 10457-7626

Mailing address

PO Box 260
Irvington, NY 10533-0260
Phone (718) 518-5232

Other identifiers 7

IdentifierTypeStateIssuer
03347266MedicaidNY
1689833303OtherNYNPI
00436677MedicaidNY
01404737MedicaidNY
1043263882OtherNPI
1144391251OtherNPI
02738810MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060203000592 NY Part B Supplier - Clinic/Group Practice 5395759872 Receives reassigned benefits from 5 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

1650 Selwyn Ave
Apt 8G
Bronx, NY 10457
Phone (718) 518-5232

1940 Webster Ave
Bronx, NY 10457
Phone (718) 299-9292

3468 Park Ave
#N
Bronx, NY 10456
Phone (718) 401-2836

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1851455885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105330260",
            "telephone_number": "718-518-5232",
            "fax_number": "718-518-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SELWYN AVE",
            "address_2": "8-G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577626",
            "telephone_number": "718-518-5232",
            "fax_number": "718-518-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONX LEBANON NEPHROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2012-05-07",
        "deactivation_date": "2012-03-28",
        "reactivation_date": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "UDAY",
        "authorized_official_first_name": "KALPANA",
        "authorized_official_title_or_position": "MANAGER/PARTNER",
        "authorized_official_telephone_number": "718-518-5232",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "255628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03347266",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689833303",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00436677",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01404737",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043263882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144391251",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02738810",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.