Individual provider Active NPI

Donald E Chudy, DPM

  • Podiatrist
  • Mesa, AZ
National Provider Identifier
1871557140
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0202 Issued in AZ
Practice address
4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4676
Phone
(480) 964-1715
Fax
(480) 834-5525
NPI assigned
Apr 13, 2006
Last updated
Aug 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0202 AZ Primary

Addresses

Primary practice location

4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4676

Mailing address

4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4676
Phone (480) 964-1715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051005000022 AZ Practitioner - Podiatry 9335174713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4824 E Baseline Rd
Suite 107
Mesa, AZ 85206-4677
Phone (480) 964-1715

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue66
Removal of skin lesions21
Removal of nail tissue892
Removal or shaving of skin growth675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0202AZMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Donald E. Chudy, DPM, PC Podiatrist CurrentSince Sep 1, 2007 Accepting new patients

Locations

850 S Ironwood Dr
Ste 104
Apache Junction, AZ 85120
Phone (480) 218-1328

4824 E Baseline Rd
Ste 107
Mesa, AZ 85206
Phone (480) 964-1715

Organizations & group practices 1

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1871557140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-964-1715",
            "fax_number": "480-834-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-964-1715",
            "fax_number": "480-834-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUDY",
        "first_name": "DONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.