Individual provider Active NPI

Chase Kenneth Hudak, MD

  • Student in an Organized Health Care Education/Training Program
  • Elizabeth, NJ
National Provider Identifier
1669111928
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
655 E Jersey St
Elizabeth, NJ 07206-1259
Phone
(330) 760-5089
NPI assigned
Jun 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

655 E Jersey St
Elizabeth, NJ 07206-1259

Mailing address

3037 Kingston Cir
Silver Lake, OH 44224-3113
Phone (330) 760-5089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20251120000246 NJ Practitioner - Psychiatry 2264924026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 W Gilbert St
Tinton Falls, NJ 07701-4948

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group, PC CurrentSince Sep 8, 2025 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Sep 8, 2025 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Sep 8, 2025 Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Organizations & group practices 3

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1669111928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 KINGSTON CIR",
            "city": "SILVER LAKE",
            "state": "OH",
            "postal_code": "442243113",
            "telephone_number": "330-760-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061259",
            "telephone_number": "330-760-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "CHASE",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.