MARY N KUDOJA (FNP-BC) – Family Nurse Practitioner, NPI 1770945263

MARY N KUDOJA (FNP-BC) is a healthcare provider. based in Green bay, Wisconsin. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 10001428 (OR). The NPI Number for MARY N KUDOJA (FNP-BC) is 1770945263

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
MARY N KUDOJA (FNP-BC)
NPI
1770945263
Phone
(920) 496-4700
Address
2502 S Ashland Ave
Enumeration Date
23 March 2016
Last Update Date
5 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5302832121
Graduation Year
2015 (11 years ago)
PAC ID
3870892417
Group Practice PAC ID
8224930466
Professional Enrollment ID
I20230825000828
Address ID
CA959719507QU1065XRDXX400

Contacts

Secure Messaging
him@marshfieldclinichealthsystem.cernerdirect.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness85
Years active:10State licenses:2Other namesUpdated within 12 months

6,035 NURSE PRACTITIONER in WI

Provider Addresses for MARY N KUDOJA (FNP-BC)

  • 2502 S Ashland Ave

    Green Bay, WI 543045252

    Phone: (920) 496-4700

    Type: Location

  • 9576 Hwy 70

    Minocqua, WI 545489067

    Phone: (715) 358-1767

    Type: Location

  • Prevea Ashwaubenon Health Center, 2502, South Ashland Avenue, Green Bay, Brown County, Wisconsin, 54304, United States

    GREEN BAY, WI 543045252

    Phone: (920) 496-4700

    Type: Location

  • 10151 SE SUNNYSIDE RD STE 100

    CLACKAMAS, OR 970155705

    Phone: (503) 659-0880

    Fax: (503) 659-0880

    Type: Location

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: 2016-05-03

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
I20160503000506INurse PractitionerWITBD

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
99213Established patient office or other outpatient visit, 20-29 minutes10093$0
99214Established patient office or other outpatient visit, 30-39 minutes3231$0
View full utilization report →

Insurance plans in this area (ZIP 54304)

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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: 8224930466View full group profile
NameSpecialtyState
Physician AssistantCA
U R O L O G YNV
Certified Nurse Midwife (Cnm)MO
Family PracticeWI
U R O L O G YNV
Physician AssistantMI
Family PracticeCA
Diagnostic RadiologyWI
Diagnostic RadiologyNV
Family PracticeCA

Reviews

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Frequently asked questions

Does MARY N KUDOJA (FNP-BC) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MARY N KUDOJA (FNP-BC) uses 1770945263.
Can I rely on MARY N KUDOJA (FNP-BC) being an active provider?
As of the registry snapshot, MARY N KUDOJA (FNP-BC) is marked active.
What taxonomy line describes MARY N KUDOJA (FNP-BC)?
For research purposes, treat MARY N KUDOJA (FNP-BC) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does MARY N KUDOJA (FNP-BC) serve?
MARY N KUDOJA (FNP-BC)'s listing highlights Green Bay, Wisconsin; more addresses can appear in NPPES.
Why does MARY N KUDOJA (FNP-BC) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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