Individual provider Active NPI

Michael Mark Rudoni

  • Chiropractor
  • Oviedo, FL
National Provider Identifier
1528112760
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7195 Issued in FL
Practice address
2200 Winter Springs Blvd Ste 101
Oviedo, FL 32765-9346
Phone
(407) 359-7246
Fax
(407) 359-2225
NPI assigned
Jan 23, 2007
Last updated
Sep 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7195 FL Primary

Addresses

Primary practice location

2200 Winter Springs Blvd Ste 101
Oviedo, FL 32765-9346

Mailing address

2200 Winter Springs Blvd Ste 101
Oviedo, FL 32765-9346
Phone (407) 359-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120531000474 FL Practitioner - Chiropractic 8729092739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2200 Winter Springs Blvd
Suite 101
Oviedo, FL 32765-9346
Phone (407) 359-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7195FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
David a. Craig, DC, PA Chiropractor PastSince Sep 20, 2014 Accepting new patients

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, 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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1528112760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 WINTER SPRINGS BLVD STE 101",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659346",
            "telephone_number": "407-359-7246",
            "fax_number": "407-359-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WINTER SPRINGS BLVD STE 101",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659346",
            "telephone_number": "407-359-7246",
            "fax_number": "407-359-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDONI",
        "first_name": "MICHAEL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "7195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.