Individual provider Active NPI

Judith Ann Nudelman, MD

  • Family Medicine Physician
  • Providence, RI
National Provider Identifier
1396701249
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD07022 Issued in RI
Practice address
530 N Main St
Providence, RI 02904-5762
Phone
(401) 415-9500
Fax
(401) 415-9515
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD07022 RI Primary

Addresses

Primary practice location

530 N Main St
Providence, RI 02904-5762

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jnudelman59214@HCNetwork.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20110211000587 RI Practitioner - Family Practice 7012197742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Community Health Centers, Inc CurrentSince Feb 5, 2013 Accepting new patients

Locations

40 Candace St
Providence, RI 02908
Phone (401) 444-0550

375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

1 Warren Way
Providence, RI 02905
Phone (401) 444-0400

239 Cranston St
Providence, RI 02907
Phone (401) 444-0580

31 Atwood St
Providence, RI 02909
Phone (401) 444-0590

530 N Main St
Providence, RI 02904
Phone (401) 274-2500

Interoperability endpoints

  • Direct secure messaging: jnudelman59214@hcnetwork.direct-ci.com

Organizations & group practices 1

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1396701249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-415-9500",
            "fax_number": "401-415-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUDELMAN",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD07022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnudelman59214@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 N Main St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029045762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.