Marilyn W Fudge, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME79050 Issued in FL

Practice address

700 6TH St S
St Petersburg, FL 33701-4815

Phone

(727) 893-6198

NPI assigned

Dec 16, 2005

Last updated

May 21, 2015By 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

Enrolled in FL

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.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Florida College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mfudge189250@orlandohealth.medalliesdirect.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.

• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Medical Group

  • Cardiovascular Disease Physician
  • St Petersburg, FL
  • NPI 1518572551
  Medicare reassignment Care Compare group NPD
• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Imaging Center

  • Radiology Clinic/Center
  • St Petersburg, FL
  • NPI 1285240192
  NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ohi West, Inc

  dba Bayfront Health St Petersburg

  • General Acute Care Hospital
  • St Petersburg, FL
  • NPI 1154399749
  Care Compare affiliation

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1306822887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014815",
            "telephone_number": "727-893-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014815",
            "telephone_number": "727-893-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDGE",
        "first_name": "MARILYN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME79050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264650100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Frouws
• Beth Brazin Frumkin, PH.D.
• Danielle Frye
• William Frye, PHD
• Marieta Georgieva Fryer, APRN
• James M Fuelner, CO
• Laura G Fuentevilla, ARNP
• Full Circle MD
• Full Circle Medical, LLC
• Christie Jo Fuller, ARNP

• Obstetrics & Gynecology Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.

Verify at the official NPI Registry.