Michelle K Sudo, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS009616L Issued in PA

Practice address

1102 Highway 315 Blvd
Wilkes Barre, PA 18702-6943

Phone

(570) 235-1470

Fax

(570) 550-9356

NPI assigned

Mar 9, 2006

Last updated

Mar 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drsudo@mykids.opdirect.net

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.

• My Kids Pediatric Partners PC

  • Pediatrics Physician
  • Wilkes Barre, PA
  • NPI 1407355472
  NPD (past) Authorized official

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1215905864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026943",
            "telephone_number": "570-235-1470",
            "fax_number": "570-550-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026943",
            "telephone_number": "570-235-1470",
            "fax_number": "570-550-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDO",
        "first_name": "MICHELLE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS009616L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001677040",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Strony, MD
• Ronald Strony, MD
• Abdullah Subhan
• Faiz Ali Subzposh, M.D.
• Jennifer Suda
• Albert M Sukowaski, R.N.
• Mohanad Sulaiman, MD
• Annpat Sullivan, DPT
• Brett Sullivan
• Harley Breanna Sullivan

• Pediatrics Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.