Individual provider Active NPI

Kafi Rudolph, D.O.

  • Family Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1023499340
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB10395700 Issued in NJ
Practice address
1210 Brace Rd Ste 103
Cherry Hill, NJ 08034-3213
Phone
(856) 536-1515
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB10395700 NJ Primary

Addresses

Primary practice location

1210 Brace Rd Ste 103
Cherry Hill, NJ 08034-3213

Mailing address

1 Federal St Ste 200
Camden, NJ 08103-1088
Phone (848) 288-6935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180815003016 NJ Practitioner - Family Practice 7618226267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers New Jersey Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cooper Care Alliance, PCGroup PAC ID 5890110563, 118 clinicians

Practice addresses (Care Compare)

1210 Brace Rd
Suite 103
Cherry Hill, NJ 08034-3213
Phone (856) 536-1515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MB10395700NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Care Alliance, PC CurrentSince Jun 1, 2025 Accepting new patients
Family Physicians at Burlington Family Medicine Past Accepting new patients

Locations

1816 Route 541
Ste 102
Burlington, NJ 08016
Phone (609) 747-0870

1210 Brace Rd
Ste 103
Cherry Hill, NJ 08034
Phone (856) 342-2034

901 Route 168
Ste 210
Turnersville, NJ 08012
Phone (856) 227-1221

Interoperability endpoints

  • Direct secure messaging: krudolph317602@direct.cooperhealth.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1023499340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "848-288-6935",
            "fax_number": "732-790-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 BRACE RD STE 103",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343213",
            "telephone_number": "856-536-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "KAFI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10395700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.