Individual provider Active NPI

Marion E. Rudek, CRNP

  • Pediatric Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1013275734
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
UP005607D Issued in PA
Practice address
1405 Shady Ave
Pittsburgh, PA 15217-1350
Phone
(412) 420-2400
NPI assigned
May 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X UP001534J PA
Pediatric Nurse Practitioner 363LP0200X UP005607D PA Primary

Addresses

Primary practice location

1405 Shady Ave
Pittsburgh, PA 15217-1350

Mailing address

733 Bayridge Ave
Pittsburgh, PA 15226-2111
Phone (412) 302-8422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
UP001534JPAMDNeonatal Nurse Practitioner
UP005607DPAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Aug 3, 2015 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Aug 3, 2015 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1013275734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 BAYRIDGE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152262111",
            "telephone_number": "412-302-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SHADY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152171350",
            "telephone_number": "412-420-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDEK",
        "first_name": "MARION",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "PA",
            "license": "UP001534J",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "UP005607D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.