Individual provider Active NPI

Sandra Lynn Hudak, DPM

  • Podiatrist
  • Wilmington, DE
National Provider Identifier
1831289610
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1-0000171 Issued in DE
Practice address
2018 Naamans Rd
#1
Wilmington, DE 19810-2659
Phone
(302) 528-7964
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1-0000171 DE Primary

Addresses

Primary practice location

2018 Naamans Rd
#1
Wilmington, DE 19810-2659

Mailing address

2018 Naamans Rd
#1
Wilmington, DE 19810-2659
Phone (302) 528-7964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000827 DE Practitioner - Podiatry 9032104351 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1-0000171DEMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Foot and Ankle Center CurrentSince Mar 16, 2004 Accepting new patients
Tristate Foot and Ankle Center, LLC Podiatrist CurrentSince Mar 16, 2004 Accepting new patients

Locations

722 Yorklyn Rd
Ste 350
Hockessin, DE 19707
Phone (302) 239-1625

2018 Naamans Rd
Bldg 1
Wilmington, DE 19810
Phone (302) 475-1299

2018 Naamans Rd
Wilmington, DE 19810
Phone (302) 475-0508

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1831289610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 NAAMANS RD",
            "address_2": "#1",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198102659",
            "telephone_number": "302-528-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 NAAMANS RD",
            "address_2": "#1",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198102659",
            "telephone_number": "302-528-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DE",
            "license": "E1-0000171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.