Michael G Dudick, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X005172 Issued in NY

Practice address

377 Route 146
Clifton Park, NY 12065-3404

Phone

(518) 664-2673

Fax

(518) 664-2677

NPI assigned

Sep 20, 2005

Reactivated

Apr 11, 2006

Sex

Male

Sole proprietor

Yes

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 NY

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Michael Dudick

  • Chiropractor
  • Clifton Park, NY
  • NPI 1053418269
  NPD (past) Authorized official

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760478374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653404",
            "telephone_number": "518-664-2673",
            "fax_number": "518-664-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 ROUTE 146",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653404",
            "telephone_number": "518-664-2673",
            "fax_number": "518-664-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDICK",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005172",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Thomas Dore, PA-C
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• Amy Duclos, OTR
• Danielle Dumrese, FNP
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• Catarina Durante Bergue Alves, PHD, LP
• David D Durling, RN
• Dynamic Wellness New York LLC

• Chiropractor in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.