Dr Philip S Dudak, DC, FNP-C is a medicare enrolled "Nurse Practitioner - Family" provider in Saint Louis, Missouri. He graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Fairview Heights Medical Group Sc, Fairview Heights Medical Group Sc, Midwest Anesthesia Associates Pc and his current practice location is
11133 Dunn Rd, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 653-5228.
Dr Philip S Dudak is licensed to practice in Illinois (license number 209010226) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1720067051.
Healthcare Provider's Profile
| Full Name | Dr Philip S Dudak |
|---|
| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 12 Years |
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| Location | 11133 Dunn Rd, Saint Louis, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Philip S Dudak graduated from medical school in 2012
NPI Data:
- NPI Number: 1720067051
- Provider Enumeration Date: 01/13/2006
- Last Update Date: 07/29/2021
Medicare PECOS Information:
- PECOS PAC ID: 7911946421
- Enrollment ID: I20130620000254
Medical Identifiers
Medical identifiers for Dr Philip S Dudak such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720067051 | NPI | - | NPPES |
| 118828 | Other | IL | BCBS |
| 4400267 | Other | | UHC |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 005778 (Missouri) | Secondary |
| 363L00000X | Nurse Practitioner | 2013003629 (Missouri) | Secondary |
| 111N00000X | Chiropractor | 038006559 (Illinois) | Secondary |
| 363L00000X | Nurse Practitioner | 209010226 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2013003629 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209010226 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Fairview Heights Medical Group Sc | 6800784083 | 346 |
| Fairview Heights Medical Group Sc | 6800784083 | 346 |
| Midwest Anesthesia Associates Pc | 8921387390 | 6 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Philip S Dudak allows following entities to bill medicare on his behalf.
| Provider Name | Fairview Heights Medical Group Sc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1679503668
PECOS PAC ID: 6800784083
Enrollment ID: O20040309000650 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Philip S Dudak is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Philip S Dudak, DC, FNP-C
11125 Dunn Rd Ste 100,
Saint Louis, MO 63136-6132
Ph: (314) 653-5228 | Dr Philip S Dudak, DC, FNP-C
11133 Dunn Rd,
Saint Louis, MO 63136-6163
Ph: (314) 653-5228 |
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