Individual provider Active NPI

Diane Catherine Hudak

  • Speech-Language Pathologist
  • West Grove, PA
National Provider Identifier
1881809887
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
00645499 Issued in PA
Practice address
1015 W Baltimore Pike
West Grove, PA 19390-9459
Phone
(610) 869-1728
Fax
(610) 444-5614
NPI assigned
May 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 00645499 PA Primary

Addresses

Primary practice location

1015 W Baltimore Pike
West Grove, PA 19390-9459

Mailing address

280 Longview LN
Kennett Square, PA 19348-1752
Phone (610) 444-5614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150513000244 PA Practitioner - Qualified Speech Language Pathologist 7315047602 Reassigns benefits to 1 organization
Practice locations: Kennett Square, PA

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8 McKean Cir
West Grove, PA 19390-9760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00645499PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Simpson Therapy Services, LLC Speech-Language Pathologist CurrentSince Mar 12, 2024 Accepting new patients

Locations

150 Monument Rd
Ste 202
Bala Cynwyd, PA 19004

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1881809887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 LONGVIEW LN",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481752",
            "telephone_number": "610-444-5614",
            "fax_number": "610-444-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W BALTIMORE PIKE",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909459",
            "telephone_number": "610-869-1728",
            "fax_number": "610-444-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "DIANE",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-12",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "00645499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.