KIRSTIN FUDGE
NPI 1689567133
Physician Assistant in Rockford, IL

Q: What is Kirstin Fudge's NPI number?

The NPI number for Kirstin Fudge is 1689567133. It was assigned to this individual provider in the NPPES registry on June 2, 2025.

Q: What is Kirstin Fudge's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kirstin Fudge was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 02, 2025PECOS EnrolledAccepts Medicare Assignment

1401 E STATE ST, ROCKFORD, IL 61104(779) 696-4410 Get Directions Write a Review

NPPES record last updated: June 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kirstin Fudge NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIRSTIN FUDGE (NPI 1689567133) is an individual physician assistant in Rockford, Illinois and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, is affiliated with Uw Health, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1689567133

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKIRSTIN FUDGE

Location Address1401 E STATE STRockford, IL 61104-2315

Mailing Address1401 E State StRockford, IL 61104-2315 · (779) 696-4410

Phone(779) 696-4410

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJune 2, 2025

NPPES CertifiedJune 2, 2025

✔ NPI 1689567133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X

1401 E STATE ST, Rockford, IL 61104

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kirstin Fudge is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931603016

PECOS Enrollment IDI20250920000771

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Uw Health

Acute Care Hospitals · Rockford, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140228

Location1401 East State StreetRockford, IL 61104 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MANISHA AJIT PATEL DPT

Physical Therapist