Dr Charles Hudak & Assoc LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR CHARLES HUDAK & ASSOC LLC

Practice address

4020 Lafayette Rd
Indianapolis, IN 46254-2506

Phone

(317) 293-9314

Fax

(317) 295-0223

NPI assigned

Nov 6, 2019

Last updated

Nov 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Michael Hudak, O.D.NPI 1073522330

Title

Ceo

Phone

(317) 554-7851

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Tax ID family

Dr Charles Hudak Assoc LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr Charles Hudak & Assoc LLC

  • Optometrist
  • Plainfield, IN
  • NPI 1306480934
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Michael Hudak, O.D.

  • Optometrist
  • Indianapolis, IN
  • NPI 1073522330
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1093359689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542506",
            "telephone_number": "317-293-9314",
            "fax_number": "317-295-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542506",
            "telephone_number": "317-293-9314",
            "fax_number": "317-295-0223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 Metropolis Mile Ste 129",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IN",
            "postal_code": "461682470",
            "country_code": "US",
            "telephone_number": "317-839-6002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR CHARLES HUDAK & ASSOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-554-7851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.