Active NPI
Melvin Yudis, M.D.
- Nephrology Physician
- Willow Grove, PA
National Provider Identifier
1497854996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD-007740-E
- Practice address
- 735 Fitzwatertown Rd
Willow Grove, PA 19090-1332 - Phone
- (215) 657-2012
- Fax
- (215) 657-2018
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MD-007740-E | PA | Primary |
Addresses
Primary practice location
735 Fitzwatertown Rd
Willow Grove, PA 19090-1332
Mailing address
735 Fitzwatertown Rd
Willow Grove, PA 19090-1332
Phone (215) 657-2012
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0048669000 | Other | PA | KEYSTONE |
| 1066639 | Other | PA | CIGNA |
| 0698751 | Medicaid | PA | |
| 018693 | Other | PA | HIGHMARK BLUE SHIELD |
| 231952978 | Other | PA | TAX-ID |
| 390001332 | Other | PA | RR MEDICARE |
| 02334MD007740E | Other | PA | HEALTH PARTNERS |
| 4089599 | Other | PA | AETNA |
| 1033381 | Other | PA | KEYSTONE MERCY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-007740-E | PA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amh Medical Staff Service Fund | Current | Accepting new patients | |
| Red Willow Dialysis LLC | Past | Accepting new patients |
Locations
1200 York Rd
Abington, PA 19001
Phone (215) 481-2222
2500 Maryland Rd
Ste 400
Willow Grove, PA 19090
Phone (215) 481-3915
2510 Maryland Rd
Ste 200
Willow Grove, PA 19090
Organizations & group practices 2
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.
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-
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- NPI 1033427646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1497854996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "735 FITZWATERTOWN RD",
"city": "WILLOW GROVE",
"state": "PA",
"postal_code": "190901332",
"telephone_number": "215-657-2012",
"fax_number": "215-657-2018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 FITZWATERTOWN RD",
"city": "WILLOW GROVE",
"state": "PA",
"postal_code": "190901332",
"telephone_number": "215-657-2012",
"fax_number": "215-657-2018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUDIS",
"first_name": "MELVIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "PA",
"license": "MD-007740-E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "0048669000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1066639",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0698751",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "018693",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX-ID",
"identifier": "231952978",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "390001332",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "02334MD007740E",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4089599",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "1033381",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Willow Grove, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.