MELINDA T FUDGE (M.D.) – Psychiatry Physician, NPI 1124141379

MELINDA T FUDGE (M.D.) is a healthcare provider. based in Jenkintown, Pennsylvania. specializing in PSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. MD-047742 (PA). The NPI Number for MELINDA T FUDGE (M.D.) is 1124141379

Main info

Female
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
MELINDA T FUDGE (M.D.)
NPI
1124141379
Phone
(215) 887-9612
Address
261 OLD YORK RD
Enumeration Date
10 April 2007
Last Update Date
11 February 2022

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7076244000
Graduation Year
1990 (36 years ago)
PAC ID
2062585854
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20161020002101
Address ID
CA956889494VA1XXXXDRXX300
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

1,871 PSYCHIATRY in PA

Provider Addresses for MELINDA T FUDGE (M.D.)

  • 261 OLD YORK RD

    SUITE 634

    JENKINTOWN, PA 190463706

    Phone: (215) 887-9612

    Fax: (215) 887-9613

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-10-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161020002101IPsychiatryCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2314$0
View full utilization report →

Insurance plans in this area (ZIP 19046)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

What unique ID ties claims to MELINDA T FUDGE (M.D.)?
NPI 1124141379 is assigned to MELINDA T FUDGE (M.D.) under the national enumeration system.
Is MELINDA T FUDGE (M.D.)'s NPI currently valid?
The extract we use shows MELINDA T FUDGE (M.D.) as active.
Does MELINDA T FUDGE (M.D.) list a primary specialty?
If you are matching referrals, note Psychiatry Physician for MELINDA T FUDGE (M.D.). Clinical services aligned with this taxonomy classification.
Where is MELINDA T FUDGE (M.D.)'s primary listing?
We display Jenkintown, Pennsylvania because that is what the record indicates for MELINDA T FUDGE (M.D.).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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