Individual provider Active NPI

Melvin Yudis, M.D.

  • Nephrology Physician
  • Willow Grove, PA
National Provider Identifier
1497854996
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD-007740-E Issued in PA
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

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0048669000OtherPAKEYSTONE
1066639OtherPACIGNA
0698751MedicaidPA
018693OtherPAHIGHMARK BLUE SHIELD
231952978OtherPATAX-ID
390001332OtherPARR MEDICARE
02334MD007740EOtherPAHEALTH PARTNERS
4089599OtherPAAETNA
1033381OtherPAKEYSTONE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000203 PA Practitioner - NephrologyPractitioner - Internal Medicine 3476654278 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-007740-EPAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amh Medical Staff Service Fund CurrentSince Dec 4, 1978 Accepting new patients
Red Willow Dialysis LLC PastSince Oct 2, 2009 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.

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

Verify at the official NPI Registry.