Individual provider Active NPI

Michael S Dudas, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1841291317
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00034162 Issued in WA
Practice address
2671 NE 46TH St
Seattle, WA 98105-5041
Phone
(206) 525-8000
Fax
(206) 525-8070
NPI assigned
Aug 9, 2005
Last updated
Nov 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00034162 WA Primary

Addresses

Primary practice location

2671 NE 46TH St
Seattle, WA 98105-5041

Mailing address

2671 NE 46TH St
Seattle, WA 98105-5041
Phone (206) 525-8000

Other identifiers 4

IdentifierTypeStateIssuer
7166DUOtherWABLUE SHIELD
8219859MedicaidWA
0039577OtherWALABOR AND INDUSTRIES#
US5038593OtherWAAETNA PCP PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20070109000492 WA Practitioner - Pediatric Medicine 0143220558 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00034162WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Pediatrics CurrentSince Mar 7, 2010 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center CurrentSince Mar 7, 2010 Accepting new patients
Virginia Mason Medical Center Past Accepting new patients

Locations

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

2671 NE 46th St
Seattle, WA 98105
Phone (206) 525-8000

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

Interoperability endpoints

  • Direct secure messaging: mdudas127529@direct.seattlechildrens.org
  • Direct secure messaging: michael.dudas@direct.vmmc.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1841291317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2671 NE 46TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055041",
            "telephone_number": "206-525-8000",
            "fax_number": "206-525-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 NE 46TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055041",
            "telephone_number": "206-525-8000",
            "fax_number": "206-525-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDAS",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00034162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "7166DU",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8219859",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES#",
            "identifier": "0039577",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PCP PIN",
            "identifier": "US5038593",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.