Active NPI
Robin Renae Tudor, MMS, PA-C
- Physician Assistant
- Valparaiso, IN
National Provider Identifier
1285884817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10001201A
- Practice address
- 85 E US Highway 6 Ste 310
Valparaiso, IN 46383 - Phone
- (219) 983-6380
- Fax
- (219) 983-6080
- NPI assigned
- Sep 18, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10001201A | IN | Primary |
Addresses
Primary practice location
85 E US Highway 6 Ste 310
Valparaiso, IN 46383
Mailing address
2022 Kelle Dr
Chesterton, IN 46304-8708
Phone (219) 364-3616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1084333 | Other | IN | NCCPA |
Other names 1
- Robin Renae Smolak
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | robin.tudor.1@2340.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
650 Dickinson Rd
Chesterton, IN 46304-3387
Hospital & facility affiliations
- Northwest Health - Porter
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.68 of 100
- Quality
- 76.2
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Porter Physician Services LLC | 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.
-
- Family Medicine Physician
- Valparaiso, IN
- NPI 1508075680
-
- Internal Medicine Physician
- Portage, IN
- NPI 1457566309
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Valparaiso, IN
- NPI 1215151154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600387200000",
"number": "1285884817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2022 KELLE DR",
"city": "CHESTERTON",
"state": "IN",
"postal_code": "463048708",
"telephone_number": "219-364-3616",
"fax_number": "219-364-3610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 E US HIGHWAY 6 STE 310",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "46383",
"telephone_number": "219-983-6380",
"fax_number": "219-983-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUDOR",
"first_name": "ROBIN",
"middle_name": "RENAE",
"name_prefix": "Ms.",
"credential": "MMS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-18",
"last_updated": "2020-09-18",
"certification_date": "2020-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10001201A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA",
"identifier": "1084333",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "robin.tudor.1@2340.direct.athenahealth.com",
"affiliation": "N",
"address_1": "85 E US Highway 6 Ste 310",
"city": "Valparaiso",
"state": "IN",
"country_code": "US",
"postal_code": "46383",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ROBIN",
"last_name": "SMOLAK",
"middle_name": "RENAE",
"credential": "MMS, PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.