Active NPI
Stephen Rudnick, OD
- Optometrist
- Stroudsburg, PA
National Provider Identifier
1851484893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0EG000650
- Practice address
- 1036 N 9TH St
Stroudsburg, PA 18360-1210 - Phone
- (570) 421-2680
- Fax
- (570) 421-2713
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0EG000650 | PA | Primary |
Addresses
Primary practice location
1036 N 9TH St
Stroudsburg, PA 18360-1210
Mailing address
1036 N 9TH St
Stroudsburg, PA 18360-1210
Phone (570) 421-2680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0EG000650 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273795200000",
"number": "1851484893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1036 N 9TH ST",
"city": "STROUDSBURG",
"state": "PA",
"postal_code": "183601210",
"telephone_number": "570-421-2680",
"fax_number": "570-421-2713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 N 9TH ST",
"city": "STROUDSBURG",
"state": "PA",
"postal_code": "183601210",
"telephone_number": "570-421-2680",
"fax_number": "570-421-2713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDNICK",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2010-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "0EG000650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.