Active NPI
Marla Weissler Dudak, M.D.
- Surgical Oncology Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- 13143314-1205
- Practice address
- 1220 E 3900 S Ste 4I
Salt Lake City, UT 84124-1383 - Phone
- (801) 948-2380
- NPI assigned
- Jun 28, 2006
- Last updated
- Mar 5, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME72788 | FL | |
| Surgical Oncology Physician | 2086X0206X | ME72788 | FL | |
| Surgical Oncology Physician | 2086X0206X | 13143314-1205 | UT | Primary |
Addresses
Primary practice location
1220 E 3900 S Ste 4I
Salt Lake City, UT 84124-1383
Mailing address
3702 Aspen PT
Park City, UT 84098-4912
Phone (561) 706-0234
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7507281 | Other | FL | AETNA |
| P975925 | Other | FL | OPTIMUM |
| P01601033 | Other | FL | RR MEDICARE |
| 1035777 | Other | FL | CAREPLUS |
| 3080244 | Other | FL | CIGNA |
| 330975 | Other | FL | WELLCARE |
| 280120 | Other | FL | AVMED |
| P1041371 | Other | FL | FREEDOM |
| 05071 | Other | FL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- 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
- Duke University School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1220 E 3900
Suite 4I
Salt Lake City, UT 84124-1383
Phone (801) 948-2380
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME72788 | FL | MD | Surgery Physician |
| 13143314-1205 | UT | MD | Surgical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesiscare USA of Florida LLC | Surgery | Current | Accepting new patients |
| Marla W Dudak MD PC | Surgery | Current | Accepting new patients |
| Genesiscare USA of Florida LLC | Current | Accepting new patients | |
| Genesiscare USA of Florida LLC | Current | Accepting new patients | |
| Genesiscare USA of Florida LLC | Past | Accepting new patients |
Locations
9325 Glades Rd
Ste 101
Boca Raton, FL 33434
Phone (561) 482-8111
1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202
2160 Colonial Blvd
Fort Myers, FL 33907
2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212
730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119
3343 S State Road 7
Wellington, FL 33449
Phone (561) 795-8945
1220 E 3900 S
Ste 4I
Salt Lake Cty, UT 84124
Phone (801) 263-1621
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BIGEDD/Endpoint/BIGEDD
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Surgery Physician
- Salt Lake City, UT
- NPI 1407600570
-
dba Mark B Weitzenfeld MD
- Urology Physician
- Aventura, FL
- NPI 1427426113
-
dba David Schwartzwald, MD: Urology Care Specialists
- Urology Physician
- Boca Raton, FL
- NPI 1649093709
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Mark's Hospital
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1164469243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709596800000",
"number": "1154359529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 ASPEN PT",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840984912",
"telephone_number": "561-706-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 E 3900 S STE 4I",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841241383",
"telephone_number": "801-948-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDAK",
"first_name": "MARLA",
"middle_name": "WEISSLER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2024-03-05",
"certification_date": "2024-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME72788",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "FL",
"license": "ME72788",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "UT",
"license": "13143314-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7507281",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM",
"identifier": "P975925",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01601033",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREPLUS",
"identifier": "1035777",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3080244",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "330975",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "280120",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FREEDOM",
"identifier": "P1041371",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "05071",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.