Donna M Sudak, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD053312L Issued in PA

Practice address

245 N 15TH St
Mail Stop 403
Philadelphia, PA 19102-1101

Phone

(215) 873-0245

Fax

(215) 762-4259

NPI assigned

Jan 24, 2007

Last updated

Sep 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 5, 2013 through Mar 5, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1245385913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N 15TH ST",
            "address_2": "MAIL STOP 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021101",
            "telephone_number": "215-873-0245",
            "fax_number": "215-762-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N 15TH ST",
            "address_2": "MAIL STOP 403",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021101",
            "telephone_number": "215-873-0245",
            "fax_number": "215-762-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDAK",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD053312L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Thomas Sucic Jr., PHARMD
• Cereseia Sucki
• Deepak Sud, D.C.
• Brianna Suda
• Dafna Sudai, M.D.
• Sriraga Harshini Sudepalli
• William Thomas Suder Jr., CRNA
• Emily Sudhakar
• Truman Sudler
• Thanwa Sudsang, M.D.

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.