My Kids Pediatric Partners PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS009616-L Issued in PA

Legal business name

MY KIDS PEDIATRIC PARTNERS PC

Practice address

1102 Highway 315 Blvd
Wilkes Barre, PA 18702-6943

Phone

(570) 235-1470

Fax

(570) 550-9256

NPI assigned

Feb 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Michelle Kunec Sudo, DONPI 1215905864

Title

President

Phone

(570) 235-1470

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle K Sudo, DO

  • Pediatrics Physician
  • Wilkes Barre, PA
  • NPI 1215905864
  NPD (past) Authorized official
• Marissa Autumn Marino, CRNP

  • Family Nurse Practitioner
  • Wilkes Barre, PA
  • NPI 1699420232
  NPD (past)

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1407355472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026943",
            "telephone_number": "570-235-1470",
            "fax_number": "570-550-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026943",
            "telephone_number": "570-235-1470",
            "fax_number": "570-550-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY KIDS PEDIATRIC PARTNERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "SUDO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "KUNEC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-235-1470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS009616-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Murray
• Sarah Murray, CRNA
• Robert E Musser, LCSW
• Sarah Mustafa
• Christopher Egan Musto, MD
• Carol L Myers, DO
• Christine Ann Myers, LAT, ATC, OPE-C
• Lynne Mylet, RN
• Nahas and Donahue Orthodontics
• Nicole Najaka

• Pediatrics Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.