Active NPI
Mark Joseph Dudash Jr., M.D.
- Surgery Physician
- Danville, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD473878
- Practice address
- 100 N Academy Ave
Danville, PA 17822-9800 - Phone
- (570) 271-6361
- Fax
- (570) 271-5785
- NPI assigned
- Jun 6, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD61278049 | WA | |
| Surgery Physician | 208600000X | MD473878 | PA | Primary |
Addresses
Primary practice location
100 N Academy Ave
Danville, PA 17822-9800
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Other practice location 1
505 NE 87th Ave Ste 301
Vancouver, WA 98664-1965
Phone (360) 514-7374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Drexel University College of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
505 NE 87TH Ave
Suite 301
Vancouver, WA 98664-1965
Phone (360) 514-2550
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 11 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 18 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD473878 | PA | MD | Surgery Physician |
| MD61278049 | WA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Surgery | Current | Accepting new patients |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth | Past | Accepting new patients |
Locations
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854
1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100
Interoperability endpoints
- mdudash568772@direct.peacehealth.org
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.
-
- Surgery Physician
- Vancouver, WA
- NPI 1609061969
-
- Multi-Specialty Clinic/Center
- Longview, WA
- NPI 1720056187
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1124477617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144",
"fax_number": "570-271-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178229800",
"telephone_number": "570-271-6361",
"fax_number": "570-271-5785"
}
],
"practiceLocations": [
{
"address_1": "505 NE 87th Ave Ste 301",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986641965",
"country_code": "US",
"telephone_number": "360-514-7374",
"fax_number": "360-514-7384",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUDASH",
"first_name": "MARK",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-06",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD61278049",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD473878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.