NPIMap

Organization Active NPI

Dudzinski Enterprises, Inc.

  • Family Medicine Physician
  • North East, PA
National Provider Identifier
1154490480
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006274L Issued in PA
Legal business name
DUDZINSKI ENTERPRISES, INC.
Practice address
115 E Main St
North East, PA 16428-1330
Phone
(814) 725-8774
Fax
(814) 725-2391
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Dr. John E Dudzinski, D.O.NPI 1174580070
Title
Owner Physician
Phone
(814) 725-8774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X OS006274L PA Primary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X OS012532 PA

Addresses

Primary practice location

115 E Main St
North East, PA 16428-1330

Mailing address

115 E Main St
North East, PA 16428-1330
Phone (814) 725-8774

Other identifiers 1

IdentifierTypeStateIssuer
1014723860001MedicaidPA

Other names 1

  • North East Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060125000707 PA Part B Supplier - Clinic/Group Practice 7416971775 Receives reassigned benefits from 4 practitioners
Practice locations: North East, PA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: j.dudz.do@nefp.amazing-direct.com
  • Direct secure messaging: philip.devore.do@nefp.amazing-direct.com

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1154490480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E MAIN ST",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164281330",
            "telephone_number": "814-725-8774",
            "fax_number": "814-725-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E MAIN ST",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164281330",
            "telephone_number": "814-725-8774",
            "fax_number": "814-725-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUDZINSKI ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "DUDZINSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "814-725-8774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006274L",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012532",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014723860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North East Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North East, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.