Individual provider Active NPI

Zenon M Duda, D.P.M.

  • Podiatrist
  • Cape Girardeau, MO
National Provider Identifier
1215027743
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000473 Issued in MO
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

Updated by the provider on May 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
31553202MedicaidMO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050112000010 MO Practitioner - Podiatry 1153379565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000473MOMDPodiatrist

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.