Stephen Andrew Sudekum, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A19959 Issued in CA

Practice address

3421 Villa LN Ste 2B
Napa, CA 94558-3060

Phone

(707) 255-5454

Fax

(707) 255-5411

NPI assigned

Apr 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Marko Bodor MD a Professional Corporation

  • Physical Medicine & Rehabilitation Physician
  • Napa, CA
  • NPI 1851325047
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1669960605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 BEARD RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583442",
            "telephone_number": "707-255-5454",
            "fax_number": "707-255-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 VILLA LN STE 2B",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583060",
            "telephone_number": "707-255-5454",
            "fax_number": "707-255-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDEKUM",
        "first_name": "STEPHEN",
        "middle_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A19959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Stupka
• Sonya E Sturdivant Brown
• Thomas E Suard, M.D.
• Wendy Suarez Ramos
• David Suarez, M.D.
• Alexis-Rose T Sullins
• Maria Sullivan
• Hamza Sulman
• Craig Sultan, O.D.
• Kaiser Sultana, M.D.

• Physical Medicine & Rehabilitation Physician in Napa, CA
• Providers in Napa, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.

Verify at the official NPI Registry.