Active NPI
Marion E. Rudek, CRNP
- Pediatric Nurse Practitioner
- Pittsburgh, PA
National Provider Identifier
1013275734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- UP005607D
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UP001534J | PA | MD | Neonatal Nurse Practitioner |
| UP005607D | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Ridge Indian Health Service Hospital | Current | Accepting new patients | |
| Pine Ridge Indian Health Service Hospital | Current | Accepting new patients | |
| Pine Ridge Indian Health Service Hospital | Current | 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.
-
- Clinic/Center
- Martin, SD
- NPI 1003208257
-
- General Acute Care Hospital
- Pine Ridge, SD
- NPI 1497786412
-
- Clinic/Center
- Wanblee, SD
- NPI 1962559518
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.