Paul Kudlick, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT33066 Issued in FL

Practice address

2864 Wellness Ave Ste 100
Orange City, FL 32763-8335

Phone

(386) 575-4027

Fax

(386) 575-4028

NPI assigned

Nov 24, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pure PT Physical Therapy LLCGroup PAC ID 6406218924, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pure PT Physical Therapy LLC

  • Physical Therapist
  • Orange City, FL
  • NPI 1417633868
  Medicare reassignment Care Compare group NPD Authorized official
• University Rehabilitation, LLC

  • Physical Therapist
  • Port Orange, FL
  • NPI 1811185291
  Medicare reassignment NPD
• Pure PT Physical Therapy LLC

  • Physical Therapist
  • Lake Mary, FL
  • NPI 1588539142
  NPD Authorized official

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

{
    "created_epoch": "1511481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1194239459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 WELLNESS AVE STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638335",
            "telephone_number": "386-575-4027",
            "fax_number": "386-575-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 WELLNESS AVE STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638335",
            "telephone_number": "386-575-4027",
            "fax_number": "386-575-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLICK",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-24",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT33066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Senne Knight, MD
• Jared Kolment
• Kopuri Orthodontist PA
• Casey Nicole Kovacevic, MS CCC SLP
• Aaron Michael Krueger, M.D.
• Kyro Care Orange City LLC
• Erica Eban Lackey, OTR/L
• Lad Imaging, LLC
• Kathrine Lafond-Poli
• Breanne Lagg, RBT

• Physical Therapist in Orange City, FL
• Providers in Orange City, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.