MR. STEPHEN CHARLES RUDDEK PA-C NPI 1558506014

NPI Information

NPI: 1558506014
Provider Name: MR. STEPHEN CHARLES RUDDEK, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: DLP CONEMAUGH PHYSICIAN PRACTICES LLC

PECOS Registration: Yes

Address:
1086 FRANKLIN ST
JOHNSTOWN, PA
ZIP 15905
Phone: (814) 534-9407
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MR. Stephen Charles Ruddek, PA-C is a surgical physician assistant in Johnstown, PA with 26 years of experience. MR. Stephen Charles Ruddek, PA-C NPI is 1558506014. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1086 FRANKLIN ST
JOHNSTOWN, PA
ZIP 15905-305
Phone: (814) 534-9407

The NPI 1558506014 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/11/2008 and was last updated on 6/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	MA002725L	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	260884	MEDICARE PIN	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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