Active NPI
Maria L Fudala, P.A.
- Medical Physician Assistant
- Plymouth Meeting, PA
National Provider Identifier
1891812863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA051378
- Practice address
- 545 W Germantown Pike
Suite 100
Plymouth Meeting, PA 19462-1349 - Phone
- (484) 351-8268
- Fax
- (484) 351-8275
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | MA051378 | PA | |
| Medical Physician Assistant | 363AM0700X | MA051378 | PA | Primary |
Addresses
Primary practice location
545 W Germantown Pike
Suite 100
Plymouth Meeting, PA 19462-1349
Mailing address
545 W Germantown Pike
Suite 100
Plymouth Meeting, PA 19462-1349
Phone (484) 351-8268
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA051378 | PA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marlene J. Mash, M.D., P.C. | Medical | Past | Accepting new patients |
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": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552953600000",
"number": "1891812863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 W GERMANTOWN PIKE",
"address_2": "SUITE 100",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194621349",
"telephone_number": "484-351-8268",
"fax_number": "484-351-8275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 W GERMANTOWN PIKE",
"address_2": "SUITE 100",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194621349",
"telephone_number": "484-351-8268",
"fax_number": "484-351-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUDALA",
"first_name": "MARIA",
"middle_name": "L",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2019-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "PA",
"license": "MA051378",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA051378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth Meeting, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.