Individual provider Active NPI

Matthew Shawn Duddy, D.C

  • Chiropractor
  • Avondale, PA
National Provider Identifier
1487736914
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC004583L Issued in PA
Practice address
417 Pennsylvania Ave.
Avondale, PA 19311-0297
Phone
(610) 268-8122
Fax
(610) 268-3103
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC004583L PA Primary

Addresses

Primary practice location

417 Pennsylvania Ave.
Avondale, PA 19311-0297

Mailing address

417 Pennsylvania Ave
Avondale, PA 19311-1120
Phone (610) 268-8122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000459 PA Practitioner - Chiropractic 0840361275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

417 Pennsylvania Ave
Avondale, PA 19311-1120
Phone (610) 268-8122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC004583LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Avondale Chiropractic PC Chiropractor CurrentSince Jul 7, 1997 Accepting new patients

Locations

417 Pennsylvania Ave
Avondale, PA 19311
Phone (610) 268-8122

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1487736914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 PENNSYLVANIA AVE",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193111120",
            "telephone_number": "610-268-8122",
            "fax_number": "610-268-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 PENNSYLVANIA AVE.",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193110297",
            "telephone_number": "610-268-8122",
            "fax_number": "610-268-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDDY",
        "first_name": "MATTHEW",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC004583L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.