Paul Edward Kudelko II, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

DO 2430 Issued in TN

Practice address

353 New Shackle Island Rd
Suite 300C
Hendersonville, TN 37075-2379

Phone

(615) 824-0043

Fax

(615) 822-1690

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine

Education

Nova Southeastern College of Osteo Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tristar Tennessee Heart and Vascular LLCGroup PAC ID 2567811474, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Hendersonville Medical Center Hospital, Hendersonville, TN, CCN 440194
• Tristar Skyline Medical Center Hospital, Nashville, TN, CCN 440006
• Tristar Northcrest Medical Center Hospital, Springfield, TN, CCN 440065
• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161
• Macon Community Hospital Hospital, Lafayette, TN, CCN 441305

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.kudelko.1@16055.direct.athenahealth.com
• Direct secure messaging: paul.kudelko@hca1.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/3880/brand/1/csg/1/fhir/r4

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.

• Tristar Tennessee Heart and Vascular LLC

  • Cardiovascular Disease Physician
  • Hendersonville, TN
  • NPI 1114708906
  Medicare reassignment Care Compare group NPD
• Sumner Physician Practices LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Gallatin, TN
  • NPI 1720572209
  Medicare reassignment NPD
• Sumner Physician Practices LLC

  • Gastroenterology Physician
  • Hendersonville, TN
  • NPI 1124438601
  NPD
• Sumner Physician Practices, LLC

  • Interventional Cardiology Physician
  • Gallatin, TN
  • NPI 1417782194
  NPD
• Family Health Care of Hendersonville, PLLC

  • Family Medicine Physician
  • Hendersonville, TN
  • NPI 1326073396
  NPD (past)
• Saint Thomas Cardiology Consultants, PC

  • Cardiovascular Disease Physician
  • Nashville, TN
  • NPI 1871607580
  NPD (past)
• Pinellas Ekg Interpreters Inc

  • Cardiovascular Disease Physician
  • Clearwater, FL
  • NPI 1013952977
  NPD (past)

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

• HCA Health Services of Tennessee, Inc.

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation
• Hendersonville Hospital Corporation

  • General Acute Care Hospital
  • Hendersonville, TN
  • NPI 1538114434
  Care Compare affiliation
• Hti Memorial Hospital Corporation

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1295780476
  Care Compare affiliation
• Macon County General Hospital, Inc.

  • Critical Access Hospital
  • Lafayette, TN
  • NPI 1417938846
  Care Compare affiliation
• Springfield Health Services, LLC

  • General Acute Care Hospital
  • Springfield, TN
  • NPI 1093397184
  Care Compare affiliation

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1225027014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD",
            "address_2": "SUITE 300C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752379",
            "telephone_number": "615-824-0043",
            "fax_number": "615-822-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD",
            "address_2": "SUITE 300C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752379",
            "telephone_number": "615-824-0043",
            "fax_number": "615-822-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDELKO",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "DO 2430",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "DO 2430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1530417",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAUL.KUDELKO@hca1.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "353 New Shackle Island Rd",
            "address_2": "SUITE 300C",
            "city": "Hendersonville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370752379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kroger Limited Partnership I
• Kroger Limited Partnership I
• Caili Krohn
• Peter B Kroll, M.D.
• Brynn Krutmeier
• Sabrina Ann La Croix
• Marie E. La Vasque, MS, MA
• Casey Lacefield, MS, CCC-SLP
• Beth Lackey, DC
• Billy Winnard Lafever Jr., D.D.S

• Cardiovascular Disease Physician in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.
• 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.