Individual provider Active NPI

Matthew Edward Dudek, DPT

  • Orthopedic Physical Therapist
  • Miami Gardens, FL
National Provider Identifier
1245600030
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
29746 Issued in FL
Practice address
1893 NE Miami Gardens Dr
Miami Gardens, FL 33179-5035
Phone
(239) 699-2882
NPI assigned
Oct 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 29746 FL Primary

Addresses

Primary practice location

1893 NE Miami Gardens Dr
Miami Gardens, FL 33179-5035

Mailing address

3513 SE 8TH Ave
Cape Coral, FL 33904-4902
Phone (239) 699-2882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29746FLMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1245600030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 SE 8TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339044902",
            "telephone_number": "239-699-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 NE MIAMI GARDENS DR",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331795035",
            "telephone_number": "239-699-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "MATTHEW",
        "middle_name": "EDWARD",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "29746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.