Active NPI
Sarah Ellsworth Dudley, PA-C
- Physician Assistant
- Kettering, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 3700 Southern Blvd Ste 300
Kettering, OH 45429-1265 - Phone
- (937) 643-9299
- Fax
- (937) 643-2343
- NPI assigned
- Dec 16, 2018
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
3700 Southern Blvd Ste 300
Kettering, OH 45429-1265
Mailing address
3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3188
Other practice location 1
30 E Apple St Ste 5254A
Dayton, OH 45409-2939
Phone (937) 208-4200
Other practice location 2
30 E Apple St Ste 5254
Dayton, OH 45409
Phone (937) 208-4200
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sdudley787009@direct.ketteringhealth.org | ||
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646
3700 Southern Blvd
Kettering, OH 45429-1265
4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309
4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751
7567 Central Parke Blvd
A
Mason, OH 45040-6852
Hospital & facility affiliations
- Kettering Health Main Campus
- Kettering Health Dayton
- Soin Medical Center
- Kettering Health Miamisburg
- Kettering Health Troy
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.34 of 100
- Quality
- 63.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.14
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Health Specialists Inc | Physician Assistant | Current | Accepting new patients |
| Premier Health Specialists Inc | Current | Accepting new patients | |
| Alliance Physicians, Inc. | Current | Accepting new patients | |
| Alliance Physicians Inc | Current | Accepting new patients |
Locations
30 E Apple St
Ste 5254A
Dayton, OH 45409
7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891
425 W Grand Ave
Ste 1003
Dayton, OH 45405
Phone (937) 226-7898
30 E Apple St
Ste 5254
Dayton, OH 45409
Phone (844) 277-2894
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
3700 Southern Blvd
Ste 300
Kettering, OH 45429
Phone (937) 395-8002
3170 Kettering Blvd
Bldg B3
Moraine, OH 45439
Phone (937) 991-3188
450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773
1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
-
- Family Medicine Physician
- Kettering, OH
- NPI 1437125572
-
- Internal Medicine Physician
- Moraine, OH
- NPI 1194958223
Physician Assistant
-
- Physical Therapist
- Mason, OH
- NPI 1326126061
-
- Family Medicine Physician
- Fairfield, OH
- NPI 1922355999
-
- Foot & Ankle Surgery Podiatrist
- Dayton, OH
- NPI 1902211287
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
- General Acute Care Hospital
- Troy, OH
- NPI 1023587045
-
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
- General Acute Care Hospital
- Miamisburg, OH
- NPI 1316966518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1124599451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 KETTERING BLVD BLDG B3",
"city": "MORAINE",
"state": "OH",
"postal_code": "454391924",
"telephone_number": "937-991-3188",
"fax_number": "937-223-9811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 SOUTHERN BLVD STE 300",
"city": "KETTERING",
"state": "OH",
"postal_code": "454291265",
"telephone_number": "937-643-9299",
"fax_number": "937-643-2343"
}
],
"practiceLocations": [
{
"address_1": "30 E Apple St Ste 5254A",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454092939",
"country_code": "US",
"telephone_number": "937-208-4200",
"fax_number": "937-208-4205",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "30 E Apple St Ste 5254",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "45409",
"country_code": "US",
"telephone_number": "937-208-4200",
"fax_number": "937-208-2678",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUDLEY",
"first_name": "SARAH",
"middle_name": "ELLSWORTH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-16",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sdudley787009@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "3700 Southern Blvd Ste 300",
"city": "Kettering",
"state": "OH",
"country_code": "US",
"postal_code": "454291265",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
"affiliation": "N",
"address_1": "3700 Southern Blvd Ste 300",
"city": "Kettering",
"state": "OH",
"country_code": "US",
"postal_code": "454291265",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.