Individual provider Active NPI

Justin Joseph Tudino, DO

  • Family Medicine Physician
  • Richmond, IN
National Provider Identifier
1801242482
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02006098A Issued in IN
Practice address
1100 Reid Pkwy
Richmond, IN 47374-1157
Phone
(765) 983-3492
Fax
(765) 983-7958
NPI assigned
May 12, 2016
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02006098A IN Primary

Addresses

Primary practice location

1100 Reid Pkwy
Richmond, IN 47374-1157

Mailing address

2405 S G St
Richmond, IN 47374-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200727003544 IN Practitioner - HospitalistPractitioner - Family Practice 8729370010

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jtudino301637@reidhealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1801242482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 S G ST",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473746550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3492",
            "fax_number": "765-983-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDINO",
        "first_name": "JUSTIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02006098A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.