Mary E Dudzik, MD
Individual provider Active NPI Family Medicine Physician · Brewer, ME
NPI 1598735722 · NPPES record last updated Aug 4, 2023
Key facts
- NPI
- 1598735722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD13330 (ME)
- Practice address
- 735 Wilson St
Brewer, ME 04412-1000 - Phone
- (079) 891-5672
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Tufts University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Penobscot Community Health Center
Practice addresses (Care Compare)
735 Wilson St
Brewer, ME 04412-1000
Phone (207) 989-1567
Hospital & facility affiliations
- Centerwell Home Health
- St Joseph Homecare
- St Joseph Hospital
- Northern Light Eastern Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.43 of 100
- Quality
- 8.29
- Promoting interoperability
- 100
- Improvement activities
- 0
- Cost
- 66.46
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060816000331 | ME | Practitioner - Family Practice | 4880697648 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013330 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penobscot Community Health Center | Current |
Accepting new patients | |
| Penobscot Community Health Center | Current |
Accepting new patients | |
| Penobscot Community Health Center | Past | Accepting new patients | |
| Magnolia Assisted Living, LLC | Past | Accepting new patients | |
| Mount Desert Island Hospital | Past | Accepting new patients |
Locations
1012 Union St
Ste 3
Bangor, ME 04401
Phone (207) 404-8040
1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407
735 Wilson St
Brewer, ME 04412
Phone (207) 989-1567
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD13330 | ME | Yes |
| Family Medicine Physician | 207Q00000X | 013330 | ME |
Addresses
Primary practice location
735 Wilson St
Brewer, ME 04412-1000
Mailing address
PO Box 1599
Bangor, ME 04402-1599
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11160 | Other | ME | ANTHEM |
| 1790764512-003 | Medicaid | ME | |
| MD13330 | Other | ME | MAINE LICENSE |
Other providers in Brewer, ME
- Dana J Doody
- Christopher Davis Dorr
- Karen Doten
- Taylor Maye Doucette
- Jenna Dubord
- Leo J. Dugal Jr.
- Jessica Rachel Dumais
- Stephen Peter Duncan-Morin
- Adam Duvall
- Holly Joan Dyer
All providers in Brewer, ME · Family Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.