NPIMap

Individual provider Active NPI

Dan T. Tudor, MD

  • Nephrology Physician
  • Sanford, FL
National Provider Identifier
1942275730
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME 94020 Issued in FL
Practice address
419 E 1St St
Sanford, FL 32771-1407
Phone
(407) 323-5047
Fax
(407) 323-5048
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME 94020 FL Primary

Addresses

Primary practice location

419 E 1St St
Sanford, FL 32771-1407

Mailing address

PO Box 1881
Sanford, FL 32772-1881
Phone (407) 323-5047

Other identifiers 3

IdentifierTypeStateIssuer
P00369212OtherFLMEDICARE RAILROAD
275514900MedicaidFL
DF4787OtherFLMEDICARE RAILROAD

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 94020FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Nephrology Associates, L.L.P. Nephrology PastSince Jan 1, 1990 Accepting new patients
Washington Nephrology Associates, L.L.P. Nephrology PastSince Jan 1, 1990 Accepting new patients
Grant Memorial Hospital Past Accepting new patients
Grant Memorial Hospital Past Accepting new patients
West Virginia University Medical Corporation Past Accepting new patients
Washington Nephrology Associates, L.L.P. Nephrology PastSince Jan 1, 1990 Accepting new patients
Washington Nephrology Associates, L.L.P. Nephrology PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 7

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1942275730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1881",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327721881",
            "telephone_number": "407-323-5047",
            "fax_number": "407-323-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E 1ST ST",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711407",
            "telephone_number": "407-323-5047",
            "fax_number": "407-323-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR",
        "first_name": "DAN",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME 94020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00369212",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275514900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF4787",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.