Individual provider Active NPI

Michael Karl Kuduk, M.D.

  • Hospitalist Physician
  • Lexington, KY
National Provider Identifier
1306912654
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
34354 Issued in KY
Practice address
800 Rose St # H405
Lexington, KY 40536-7001
Phone
(859) 218-2919
Fax
(859) 257-1632
NPI assigned
Nov 28, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34354 KY
Hospitalist Physician 208M00000X 34354 KY Primary

Addresses

Primary practice location

800 Rose St # H405
Lexington, KY 40536-7001

Mailing address

800 Rose St # H404
Lexington, KY 40536-0001
Phone (859) 218-2919

Other identifiers 1

IdentifierTypeStateIssuer
64343544MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20170530001727 KY Practitioner - Pediatric Medicine 5890848550 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Pediatrics CurrentSince May 12, 2017 Accepting new patients
University of Kentucky Past Accepting new patients
University of Kentucky Past Accepting new patients

Locations

800 Rose St
#H405
Lexington, KY 40536
Phone (859) 218-2919

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
#H404
Lexington, KY 40536
Phone (859) 218-2581

Interoperability endpoints

  • Direct secure messaging: mkuduk32689@ukhcdirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306912654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST # H404",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-218-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST # H405",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405367001",
            "telephone_number": "859-218-2919",
            "fax_number": "859-257-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDUK",
        "first_name": "MICHAEL",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-07-21",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "34354",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "34354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64343544",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.