Individual provider Active NPI

John Eric Dudzinski, D.O.

  • Family Medicine Physician
  • North East, PA
National Provider Identifier
1174580070
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BD1063407 Issued in PA
Practice address
115 E Main St
North East, PA 16428-1330
Phone
(814) 725-8774
Fax
(814) 725-2391
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BD1063407 PA Primary

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
0010944130002MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DR.DUDZ.DO@nefp.amazing-direct.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000748 PA Practitioner - Family Practice 0042254526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dudzinski Enterprises, Inc.Group PAC ID 7416971775, 4 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

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

5930 Old French Rd
Erie, PA 16509-3656
Phone (814) 860-7816

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Dudzinski Enterprises, Inc. Family Medicine CurrentSince Jul 15, 2005 Accepting new patients
Dudzinski Enterprises Inc Past Accepting new patients
North East Family Practice Past Accepting new patients

Locations

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

Interoperability endpoints

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

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1174580070",
    "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": {
        "last_name": "DUDZINSKI",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "BD1063407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010944130002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DR.DUDZ.DO@nefp.amazing-direct.com",
            "affiliation": "N",
            "endpointDescription": "direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "115 E Main St",
            "city": "North East",
            "state": "PA",
            "country_code": "US",
            "postal_code": "164281330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North East, PA

Sources for this page

Verify at the official NPI Registry.