Active NPI
Matthew Nudelman
- Pediatrics Physician
- Palo Alto, CA
National Provider Identifier
1205456779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A209834
- Practice address
- 795 El Camino Real
Palo Alto, CA 94301-2302 - Phone
- (650) 853-3355
- NPI assigned
- Apr 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A209834 | CA | Primary |
Addresses
Primary practice location
795 El Camino Real
Palo Alto, CA 94301-2302
Mailing address
PO Box 276950
Sacramento, CA 95827-6950
Other practice location 1
6408 Bridge Rd Apt 374
Monona, WI 53713-1833
Phone (408) 687-5121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1205456779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 276950",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958276950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 EL CAMINO REAL",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943012302",
"telephone_number": "650-853-3355"
}
],
"practiceLocations": [
{
"address_1": "6408 Bridge Rd Apt 374",
"address_purpose": "LOCATION",
"city": "Monona",
"state": "WI",
"postal_code": "537131833",
"country_code": "US",
"telephone_number": "408-687-5121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NUDELMAN",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-24",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A209834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.