Individual provider Active NPI

Madison Kudja

  • Physical Therapist
  • Miami Beach, FL
National Provider Identifier
1124894969
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41086 Issued in FL
Practice address
404 Washington Ave, Unit 120
Miami Beach, FL 33139
Phone
(305) 479-2973
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT41086 FL Primary

Addresses

Primary practice location

404 Washington Ave, Unit 120
Miami Beach, FL 33139

Mailing address

5860 SW 89TH PL
Miami, FL 33173-1653
Phone (786) 202-7189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312000185 FL Practitioner - Physical Therapist in Private Practice 8527589191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
USA Sports Medicine LLCGroup PAC ID 2062828775, 6 clinicians

Practice addresses (Care Compare)

404 Washington Ave
Suite 120
Miami Beach, FL 33139-6651
Phone (305) 479-2973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41086FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
USA Sports Medicine LLC CurrentSince Dec 23, 2024 Accepting new patients

Locations

21150 Biscayne Blvd
Ste 406
Miami, FL 33180

1220 20th St
Miami Beach, FL 33139
Phone (305) 479-2973

404 Washington Ave
Ste 120
Miami Beach, FL 33139
Phone (305) 479-2973

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1124894969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 SW 89TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731653",
            "telephone_number": "786-202-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WASHINGTON AVE, UNIT 120",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "33139",
            "telephone_number": "305-479-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDJA",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.