Organization Active NPI

Comprehensive Arthritis Spine and Pain Center

  • Rheumatology Physician
  • St Augustine, FL
National Provider Identifier
1376261883
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
COMPREHENSIVE ARTHRITIS SPINE AND PAIN CENTER
Practice address
1301 Plantation Island Dr S Ste 402B
Saint Augustine, FL 32080-3118
Phone
(904) 325-9420
Fax
(469) 733-1034
NPI assigned
Aug 19, 2022
Last updated
Aug 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Authorized official

Name
Ramsha Kudia, MDNPI 1811359151
Title
Owner
Phone
(904) 325-9420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X Primary
Pain Medicine Physician 208VP0000X

Addresses

Primary practice location

1301 Plantation Island Dr S Ste 402B
Saint Augustine, FL 32080-3118

Mailing address

1301 Plantation Island Dr S Ste 402B
Saint Augustine, FL 32080-3118
Phone (904) 325-9420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220912001319 FL Part B Supplier - Clinic/Group Practice 4082099072 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Augustine, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1376261883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 402B",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803118",
            "telephone_number": "904-325-9420",
            "fax_number": "469-733-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 402B",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803118",
            "telephone_number": "904-325-9420",
            "fax_number": "469-733-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE ARTHRITIS SPINE AND PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "KUDIA",
        "authorized_official_first_name": "RAMSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-325-9420",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.