Active NPI
Ahmad Dib Dudar, M.D.
- Pulmonary Disease Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 4301103357
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-5269
- NPI assigned
- Jun 28, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301103357 | MI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 4301103357 | MI | |
| Pulmonary Disease Physician | 207RP1001X | 4301103357 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-5269
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-2000
Hospital & facility affiliations
- Memorialcare Long Beach Medical Center
- Providence Little Co of Mary Med Ctr San Pedro
- Providence Little Company of Mary Med Ctr Torrance
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inpatient Specialists of California, PC | Internal Medicine | Current | Accepting new patients |
| Mission Hospital Regional Medical Center | Past | Accepting new patients | |
| Saddleback Memorial Medical Center | Past | Accepting new patients |
Locations
2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655
2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000
3605 Long Beach Blvd
Ste 405
Long Beach, CA 90807
Phone (562) 424-8000
10625 Leffingwell Rd
Norwalk, CA 90650
Phone (562) 864-2541
16453 Colorado Ave
Paramount, CA 90723
Phone (562) 408-7427
1300 W 7th St
San Pedro, CA 90732
Phone (310) 514-5350
1322 W 6th St
San Pedro, CA 90732
Phone (310) 514-5270
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- adudar538524@direct.memorialcare.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- San Bernardino, CA
- NPI 1952792475
-
- Rehabilitation Hospital
- Mission Viejo, CA
- NPI 1003956913
-
- Rehabilitation Hospital Unit
- Laguna Hills, CA
- NPI 1114967114
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Beach, CA
- NPI 1962442012
-
- General Acute Care Hospital
- San Pedro, CA
- NPI 1497241541
-
- General Acute Care Hospital
- San Pedro, CA
- NPI 1942247291
-
- General Acute Care Hospital
- Torrance, CA
- NPI 1902844988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467590400000",
"number": "1861832347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-5269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-5269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDAR",
"first_name": "AHMAD",
"middle_name": "DIB",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-28",
"last_updated": "2016-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301103357",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MI",
"license": "4301103357",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MI",
"license": "4301103357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 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.