Individual provider Active NPI

Heidi Hudek, P.A.

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1801102074
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051887 Issued in PA
Practice address
1015 Chestnut St Ste 512
Philadelphia, PA 19107-4305
Phone
(267) 479-4180
Fax
(215) 873-0201
NPI assigned
Aug 26, 2010
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051887 PA Primary
Medical Physician Assistant 363AM0700X MA051887 PA

Addresses

Primary practice location

1015 Chestnut St Ste 512
Philadelphia, PA 19107-4305

Mailing address

207 N Broad St FL 3
Philadelphia, PA 19107-1500
Phone (267) 479-4142

Other identifiers 1

IdentifierTypeStateIssuer
1039678100001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20211026002495 PA Practitioner - Physician Assistant 8224426127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

1703 S Broad St
Suite 300
Philadelphia, PA 19148-1536
Phone (215) 463-5333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare Heart Station CurrentSince Feb 9, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Feb 9, 2022 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1801102074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "267-479-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST STE 512",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074305",
            "telephone_number": "267-479-4180",
            "fax_number": "215-873-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDEK",
        "first_name": "HEIDI",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051887",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051887",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1039678100001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.