Organization Active NPI

Donald E. Chudy, DPM, PC

  • Foot & Ankle Surgery Podiatrist
  • Mesa, AZ
National Provider Identifier
1013104843
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0202 Issued in AZ
Legal business name
DONALD E. CHUDY, DPM, PC
Practice address
4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4676
Phone
(480) 964-1715
Fax
(480) 834-5525
NPI assigned
Sep 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Mrs. Susan L Chudy
Title
Office Supervisor
Phone
(480) 964-1715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 0202 AZ Primary

Addresses

Primary practice location

4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4676

Mailing address

4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4676
Phone (480) 964-1715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071015000006 AZ Part B Supplier - Clinic/Group Practice 7416043997 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ
O20100930070389 AZ DME Supplier - Physician - Podiatry 7416043997 Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

4824 E Baseline Rd
Ste 107
Mesa, AZ 85206
Phone (480) 964-1715

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1013104843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-964-1715",
            "fax_number": "480-834-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-964-1715",
            "fax_number": "480-834-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD E. CHUDY, DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "CHUDY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "480-964-1715",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.