Individual provider Active NPI

Richard Todd Budenz, MPH, PA-C

  • Pain Medicine Physician
  • Elk Grove, CA
National Provider Identifier
1356999007
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
57123 Issued in CA
Practice address
2372 Maritime Dr
Elk Grove, CA 95758-3639
Phone
(916) 478-0112
NPI assigned
Aug 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 57123 CA Primary

Addresses

Primary practice location

2372 Maritime Dr
Elk Grove, CA 95758-3639

Mailing address

1525 Tamarack Rd
West Sacramento, CA 95691-5123
Phone (209) 598-4175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191018002522 CA Practitioner - Physician Assistant 9436480688 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Nerve Diagnostic Center CurrentSince Oct 1, 2019 Accepting new patients
Spine & Nerve Diagnostic Center Pain Medicine CurrentSince Oct 1, 2019 Accepting new patients

Locations

2372 Maritime Dr
Elk Grove, CA 95758
Phone (408) 885-5110

1528 Eureka Rd
Ste 103
Roseville, CA 95661
Phone (916) 772-5325

Interoperability endpoints

  • Direct secure messaging: rbuddenz421943@hisp.ehr.sutterhealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1356999007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 TAMARACK RD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956915123",
            "telephone_number": "209-598-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2372 MARITIME DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957583639",
            "telephone_number": "916-478-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDENZ",
        "first_name": "RICHARD",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "MPH, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "57123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.