Christopher Pudol, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A14907 Issued in CA

Practice address

1000 Vale Terrace Dr
Vista, CA 92084-5218

Phone

(760) 631-5000

Fax

(760) 414-3892

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

College of Osteo Med of the Pacific at Pomona, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vista Community ClinicGroup PAC ID 0042120156, shared by 5 NPIs, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: christopher.pudoldo.p1@direct.vistacommunityclinic.nextgenshare.com

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.

• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Oceanside, CA
  • NPI 1649363375
  NPD (past)
• Allcare Clinic, PLLC

  • Primary Care Clinic/Center
  • Tampa, FL
  • NPI 1447516141
  NPD (past)
• Bloom Family Doctor, PLLC

  • Primary Care Clinic/Center
  • Tampa, FL
  • NPI 1013273721
  NPD (past)
• Florida Health Sciences Center Inc

  dba Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1851386080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUDOL",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8199",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274081800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irina F Proshkina, M.D.
• Sharon Provenzano, RDH
• Psycare, Inc.
• Psychology Consulting, Professional Corporation (Embrasse Resources)
• Psychology Consulting, Professional Corporation (Embrasse Treatment Center)
• Pulse Nursing Corporation
• Kari Lynn Purcott, M.D.
• Judy Puryear, CNP
• Aftab Ahmed Qazi, MD
• Kierstin Qi, PT

• Family Medicine Physician in Vista, CA
• Providers in Vista, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.