Individual provider Active NPI

Eric John Chudej, MD

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1053620013
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N7530 Issued in TX
Practice address
851 N Loop 340
Waco, TX 76705-2592
Phone
(254) 202-7500
NPI assigned
Sep 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N7530 TX Primary

Addresses

Primary practice location

851 N Loop 340
Waco, TX 76705-2592

Mailing address

PO Box 848476
Dallas, TX 75284-8476
Phone (800) 994-0371

Other practice location 1

5100 Franklin Ave
Waco, TX 76710-6922
Phone (254) 865-2166

Other identifiers 1

IdentifierTypeStateIssuer
TXB115929OtherTXMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address echudej1192794@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110304000362 TX Practitioner - Family Practice 7618159138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Family Health CenterGroup PAC ID 4183612278, 62 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2201 Macarthur Dr
Waco, TX 76708-3161
Phone (254) 202-4360

5400 Laurel Lake Dr
Waco, TX 76710-2835
Phone (254) 399-6633

7300 Bosque Blvd
Waco, TX 76710-4023
Phone (254) 202-7700

851 N Loop
340 B S and W H Clinic Bellmead
Waco, TX 76705-2592
Phone (254) 202-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N7530TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coryell County Memorial Hospital Authority Current Accepting new patients
Coryell County Memorial Hospital Authority CurrentSince May 17, 2023 Accepting new patients
Coryell County Memorial Hospital Authority CurrentSince May 17, 2023 Accepting new patients
Hillcrest Family Health Center Family Medicine CurrentSince Jul 17, 2024 Accepting new patients
Soheil Hekmat, MD, Inc. Past Accepting new patients

Locations

1507 W Main St
Gatesville, TX 76528
Phone (254) 865-8251

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

851 N Loop 340
#B
Waco, TX 76705
Phone (254) 202-7500

851 N Loop 340
Waco, TX 76705
Phone (254) 202-7500

Interoperability endpoints

  • Direct secure messaging: echudej1192794@direct.sw.org
  • Direct secure messaging: echudej1336648@direct.sw.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1053620013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848476",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848476",
            "telephone_number": "800-994-0371",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 N LOOP 340",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052592",
            "telephone_number": "254-202-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767106922",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUDEJ",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N7530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "TXB115929",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "echudej1192794@direct.sw.org",
            "affiliation": "N",
            "address_1": "851 N Loop 340",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767052592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.