Michael E. Hudson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036895 Issued in CT

Practice address

223 Cibeque Circle Road
San Carlos, AZ 85550

Phone

(928) 475-7219

Fax

(928) 475-7370

NPI assigned

Aug 30, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Internal Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dhew Ind HLTH SV HLTH SVS and MNTL HLTH AdmGroup PAC ID 1759290901, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoenix Indian Medical Center Hospital, Phoenix, AZ, CCN 030078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Phoenix Indian Medical Center

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment Care Compare group NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  dba Ak-Chin Clinic

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811006059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855500208",
            "telephone_number": "928-475-7219",
            "fax_number": "928-475-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 CIBEQUE CIRCLE ROAD",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "85550",
            "telephone_number": "928-475-7219",
            "fax_number": "928-475-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "036895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466179",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Gallenstein, PHD
• Patricia Rosa Hamrick, PSY.D.
• Karen Sue Heath, M.D.
• Georgeann Thelma Hendricks, LMSW, LISAC
• Robert Reed Henley, PH.D.
• Julia Whitener Jones, RPH
• Chul H. Kim, M.D.
• Raven Kitcheyan
• Pamela Kay Kloote, RPH
• Sasha Melisa Latonis, PHARM.D.

• Internal Medicine Physician in San Carlos, AZ
• Providers in San Carlos, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.