Craig Kenyon Udall, DPM in Goodyear, AZ - Medicare Podiatrist Provider

Craig Kenyon Udall, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Goodyear, Arizona. His current practice location is 14539 W Indian School Rd Ste 880, Goodyear, Arizona. You can reach out to his office (for appointments etc.) via phone at (623) 248-4734.

Craig Kenyon Udall is licensed to practice in Arizona (license number 0859) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1396180477.

Contact Information

	Craig Kenyon Udall, DPM
	14539 W Indian School Rd Ste 880, Goodyear, AZ 85395-9279
	(623) 248-4734
	(623) 259-7006

Map and Direction

Healthcare Provider's Profile

Full Name	Craig Kenyon Udall
Gender	Male
Speciality	Podiatrist - Foot & Ankle Surgery
Location	14539 W Indian School Rd Ste 880, Goodyear, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396180477
Provider Enumeration Date: 05/02/2013
Last Update Date: 06/04/2024

Medicare PECOS Information:

PECOS PAC ID: 0840427183
Enrollment ID: I20170711003557

Medical Identifiers

Medical identifiers for Craig Kenyon Udall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396180477	NPI	-	NPPES
8154560001	Other		MEDICARE DME
Z274188	Other	AZ	MEDICARE PTAN
270291	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
213E00000X	Podiatrist	0859 (Arizona)	Secondary
213ES0103X	Podiatrist - Foot & Ankle Surgery	0859 (Arizona)	Primary

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. Craig Kenyon Udall allows following entities to bill medicare on his behalf.

Provider Name	Rwj Podiatry Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1386384790 PECOS PAC ID: 8729466677 Enrollment ID: O20220603002585

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. Craig Kenyon Udall 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
Craig Kenyon Udall, DPM 14539 W Indian School Rd Ste 880, Goodyear, AZ 85395-9279 Ph: (623) 248-4734	Craig Kenyon Udall, DPM 14539 W Indian School Rd Ste 880, Goodyear, AZ 85395-9279 Ph: (623) 248-4734

Reviews and Comments

Podiatrist in Goodyear, AZ

Dr. Mehera Tiffanie Hormuz, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 2970 N Litchfield Rd Ste 120, Goodyear, AZ 85395 Phone: 623-935-5780
Jerome A Cohn, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 13555 W Mcdowell Rd, Suite 301, Goodyear, AZ 85395 Phone: 623-848-0123 Fax: 623-848-1173
Foot Envy Podiatrist Medicare: Medicare Enrolled Practice Location: 14539 W Indian School Rd Ste 880, Goodyear, AZ 85395 Phone: 623-248-4734 Fax: 623-259-7006
Arizona Foot & Ankle Specialists, Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 2790 North Litchfield Road, Suite 120, Goodyear, AZ 85395 Phone: 623-935-5780 Fax: 623-935-5783
Jerome A Cohn, Dpm, Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 13555 W Mcdowell Rd Ste 301, Goodyear, AZ 85395 Phone: 602-848-0123
Jerome A Cohn Dpm Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 13555 W Mcdowell Rd, Suite 301, Goodyear, AZ 85395 Phone: 623-848-0123 Fax: 623-848-1153

Craig Kenyon Udall, DPM - Medicare Podiatrist in Goodyear, AZ