John S Kundrat, MD PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

M3432 Issued in ID

Legal business name

JOHN S KUNDRAT, MD PA

Practice address

3316 4TH St
BLDG 3
Lewiston, ID 83501-4405

Phone

(208) 746-0458

Fax

(208) 743-6020

NPI assigned

Jan 7, 2013

Last updated

Jan 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John S Kundrat, MDNPI 1063589133

Title

President

Phone

(208) 746-0458

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Stephen Kundrat, MD PA

  • Ophthalmology Physician
  • Lewiston, ID
  • NPI 1063589133
  Authorized official Same address or phone

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1255678546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 4TH ST",
            "address_2": "BLDG 3",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014405",
            "telephone_number": "208-746-0458",
            "fax_number": "208-743-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 4TH ST",
            "address_2": "BLDG 3",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014405",
            "telephone_number": "208-746-0458",
            "fax_number": "208-743-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S KUNDRAT, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "KUNDRAT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-746-0458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M3432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002460100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1478601",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine A Jensen, MPS,BS,AS
• Levi Jeppson, PA-C
• Joan P Burrow DC LLC
• Amy Edwardson Johannesen, M.A., LPC, LMHC
• John J Johnson DDS PC
• John T Rietz (Optometric Vision Center)
• Amy C Johnson, RN
• Amy Dawnette Johnson, RN
• John Joseph Johnson, DDS
• Katherine Nicole Johnson, LMSW

• Ophthalmology Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.