Active NPI
Zenon M Duda, D.P.M.
- Podiatrist
- Cape Girardeau, MO
National Provider Identifier
1215027743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 000473
- Practice address
- 145 S Mount Auburn Rd
Ste B
Cape Girardeau, MO 63703-4913 - Phone
- (573) 334-1080
- Fax
- (573) 334-2748
- NPI assigned
- Oct 13, 2006
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 000473 | MO | Primary |
Addresses
Primary practice location
145 S Mount Auburn Rd
Ste B
Cape Girardeau, MO 63703-4913
Mailing address
145 S Mount Auburn Rd
Ste B
Cape Girardeau, MO 63703-4913
Phone (573) 334-1080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31553202 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050112000010 | MO | Practitioner - Podiatry | 1153379565 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000473 | MO | MD | Podiatrist |
Interoperability endpoints
- capefootclinic@cfc-mo.direct.office.nextgen.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1215027743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 S MOUNT AUBURN RD",
"address_2": "STE B",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637034913",
"telephone_number": "573-334-1080",
"fax_number": "573-334-2748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 S MOUNT AUBURN RD",
"address_2": "STE B",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637034913",
"telephone_number": "573-334-1080",
"fax_number": "573-334-2748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDA",
"first_name": "ZENON",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MO",
"license": "000473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31553202",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.