Active NPI
Mary L Budzak, MD
- Family Medicine Physician
- Yellow Springs, OH
National Provider Identifier
1023074853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35048312
- Practice address
- 1001 Xenia Ave
Yellow Springs, OH 45387-1600 - Phone
- (937) 767-7369
- Fax
- (937) 767-7703
- NPI assigned
- Apr 21, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35048312 | OH | Primary |
Addresses
Primary practice location
1001 Xenia Ave
Yellow Springs, OH 45387-1600
Mailing address
PO Box 1144
Dayton, OH 45401-1144
Phone (937) 259-9900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0102990 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35048312 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Psychological Services Association | Past | Accepting new patients | |
| Wright State Physicians Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Psychologist
- Dayton, OH
- NPI 1760483135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1023074853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1144",
"city": "DAYTON",
"state": "OH",
"postal_code": "454011144",
"telephone_number": "937-259-9900",
"fax_number": "937-259-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 XENIA AVE",
"city": "YELLOW SPRINGS",
"state": "OH",
"postal_code": "453871600",
"telephone_number": "937-767-7369",
"fax_number": "937-767-7703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDZAK",
"first_name": "MARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35048312",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0102990",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yellow Springs, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.