Individual provider Active NPI

Joshua Kevin Dudziak, NP

  • Family Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1174333017
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355751 Issued in NY
Practice address
111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3181
Phone
(716) 836-4646
NPI assigned
Jan 13, 2025
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355751 NY Primary

Addresses

Primary practice location

111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3181

Mailing address

111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3181
Phone (716) 836-4646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250313001486 NY Practitioner - Nurse Practitioner 3779005269 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
355751NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Radiology Associates LLC CurrentSince Mar 1, 2025 Accepting new patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Jun 15, 2025 Accepting new patients
Great Lakes Medical Imaging LLC CurrentSince Mar 1, 2025 Accepting new patients
Kaleida Health CurrentSince Jun 15, 2025 Accepting new patients
University Radiology at Buffalo, Inc. Past Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

3085 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 150
Cheektowaga, NY 14225
Phone (716) 844-5300

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

500 Sterling Dr
#2
Orchard Park, NY 14127

5959 Big Tree Rd
Ste 105
Orchard Park, NY 14127
Phone (716) 256-1114

3850 Saunders Settlement Rd
Ste 150
Sanborn, NY 14132

111 N Maplemere Rd
Ste 120
Williamsville, NY 14221
Phone (716) 836-4646

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1174333017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 120",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213181",
            "telephone_number": "716-836-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 120",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213181",
            "telephone_number": "716-836-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDZIAK",
        "first_name": "JOSHUA",
        "middle_name": "KEVIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.