Active NPI
Robert J Nudera, M.D.
- Otolaryngology Physician
- Aurora, IL
National Provider Identifier
1164418315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036-043320
- Practice address
- 2040 Ogden Ave
Suite 301
Aurora, IL 60504-7222 - Phone
- (630) 978-6895
- Fax
- (630) 375-2905
- NPI assigned
- Sep 23, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036-043320 | IL | Primary |
Addresses
Primary practice location
2040 Ogden Ave
Suite 301
Aurora, IL 60504-7222
Mailing address
1256 Waterford Drive
Suite 230
Aurora, IL 60504
Phone (630) 499-2404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-043320 | IL | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549497600000",
"number": "1164418315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1256 WATERFORD DRIVE",
"address_2": "SUITE 230",
"city": "AURORA",
"state": "IL",
"postal_code": "60504",
"telephone_number": "630-499-2404",
"fax_number": "630-499-2399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 OGDEN AVE",
"address_2": "SUITE 301",
"city": "AURORA",
"state": "IL",
"postal_code": "605047222",
"telephone_number": "630-978-6895",
"fax_number": "630-375-2905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUDERA",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2019-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036-043320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.