Active NPI
Kenneth J. Budowsky, MD
- Pediatrics Physician
- Hollywood, FL
National Provider Identifier
1306848759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME63492
- Practice address
- 4651 Sheridan St.
Suite #270
Hollywood, FL 33021-3422 - Phone
- (954) 989-6000
- Fax
- (954) 378-4775
- NPI assigned
- Aug 15, 2005
- 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 | ME63492 | FL | Primary |
Addresses
Primary practice location
4651 Sheridan St.
Suite #270
Hollywood, FL 33021-3422
Mailing address
4651 Sheridan St.
Suite #270
Hollywood, FL 33021-3422
Phone (954) 989-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376154100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME63492 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Medical Center, PA. | Past | Accepting new patients | |
| Vitalmd Group Holding LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Exclusive Provider Organization
- Pembroke Pines, FL
- NPI 1184842395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1306848759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4651 SHERIDAN ST.",
"address_2": "SUITE #270",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213422",
"telephone_number": "954-989-6000",
"fax_number": "954-378-4775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4651 SHERIDAN ST.",
"address_2": "SUITE #270",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213422",
"telephone_number": "954-989-6000",
"fax_number": "954-378-4775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDOWSKY",
"first_name": "KENNETH",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME63492",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "376154100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.