Individual provider Active NPI

Amy Kathryn Dudas, PA

  • Medical Physician Assistant
  • Erie, PA
National Provider Identifier
1972837540
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054025 Issued in PA
Practice address
240 W 11TH St
Second Floor
Erie, PA 16501-1758
Phone
(814) 452-2218
Fax
(814) 452-4639
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054025 PA Primary

Addresses

Primary practice location

240 W 11TH St
Second Floor
Erie, PA 16501-1758

Mailing address

240 W 11TH St
Second Floor
Erie, PA 16501-1758
Phone (814) 452-2218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091228000534 PA Practitioner - Physician Assistant 0143360032 Reassigns benefits to 1 organization
I20200417000638 NC Practitioner - Physician Assistant 0143360032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metabolic Disease Associates, Inc.Group PAC ID 5799686614, 12 clinicians

Practice addresses (Care Compare)

240 W 11TH St
Erie, PA 16501-1702
Phone (814) 452-2218

240 W 11TH St
Suite 2
Erie, PA 16501-1758

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009
  • Meadville Medical Center Hospital, Meadville, PA, CCN 390113
  • Warren General Hospital Hospital, Warren, PA, CCN 391319
  • Warren General Hospital Hospital, Warren, PA, CCN 390146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metabolic Disease Associates Current Accepting new patients

Locations

240 W 11th St
Ste 2
Erie, PA 16501
Phone (814) 452-2218

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1972837540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W 11TH ST",
            "address_2": "SECOND FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011758",
            "telephone_number": "814-452-2218",
            "fax_number": "814-452-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W 11TH ST",
            "address_2": "SECOND FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011758",
            "telephone_number": "814-452-2218",
            "fax_number": "814-452-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDAS",
        "first_name": "AMY",
        "middle_name": "KATHRYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.