Stanley Fudala, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

41002-20 Issued in WI

Practice address

500 McMillen Street
Fort Atkinson, WI 53538-1263

Phone

(950) 563-5571

Fax

(920) 563-4228

NPI assigned

Feb 23, 2006

Sex

Male

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 WI

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

Psychiatry

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fort Healthcare IncGroup PAC ID 0840189718, shared by 3 NPIs, 159 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
• Direct secure messaging: stanley.fudala@direct.forthc.com

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.

• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361
  Medicare reassignment NPD
• Fort Healthcare Inc

  • Rural Health Clinic/Center
  • Fort Atkinson, WI
  • NPI 1417450115
  NPD
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Hospital

  Care Compare affiliation
• Fort Healthcare, Inc.

  • General Acute Care Hospital
  • Fort Atkinson, WI
  • NPI 1811916281
  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356317184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MCMILLEN ST",
            "address_2": "FORT HEALTHCARE",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381233",
            "telephone_number": "920-563-5571",
            "fax_number": "920-563-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MCMILLEN STREET",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381263",
            "telephone_number": "950-563-5571",
            "fax_number": "920-563-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDALA",
        "first_name": "STANLEY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "41002-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34449000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Healthcare, Inc.
• Fort Medical Equipment LLC
• Fort Memorial Hospital
• Katherine L Fortney, OTR
• Kelly Foster, MS,CCC-SLP
• Nathaniel J Fullerton, MD
• Garrison HDH LLC
• Brenda Kristine Garrison, D.D.S.
• Lisa Gdaniec, PT
• Gregory Gehred, MD

• Psychiatry Physician in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.