Kellie A Dudy, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA20407 Issued in CA

Practice address

7471 N Fresno St
Fresno, CA 93720-2457

Phone

(559) 436-4500

Fax

(559) 261-1526

NPI assigned

Jul 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177
  Medicare reassignment Care Compare group
• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716
  Medicare reassignment
• Sharp Rees-Stealy Medical Center

  • Physical Therapist
  • Chula Vista, CA
  • NPI 1407096589
  NPD (past)

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1740419621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7471 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202457",
            "telephone_number": "559-436-4500",
            "fax_number": "559-261-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7471 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202457",
            "telephone_number": "559-436-4500",
            "fax_number": "559-261-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDY",
        "first_name": "KELLIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA20407",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadine Dubina
• Merriah Dubois-Foss
• Corey Duckworth
• Kaylen Duckworth, BS
• Isla Dudley
• Martin Philip Dueck, PHARM. D.
• Dueker Fee Physical Therapy Inc
• Erin M Dueker, P.T.
• Jacqueline Duenas Macias
• Benjamin Michael Duenas, LVN

• Physician Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.
• 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.