Individual provider Active NPI

Jorge Jara Kudin, MD

  • Pediatrics Physician
  • Wilmington, DE
National Provider Identifier
1376962936
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C1-0012077 Issued in DE
Practice address
3521 Silverside Rd Ste 1F
Wilmington, DE 19810-4900
Phone
(302) 478-2613
Fax
(302) 421-9743
NPI assigned
Apr 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X C1-0012077 DE
Pediatrics Physician 208000000X C1-0012077 DE Primary

Addresses

Primary practice location

3521 Silverside Rd Ste 1F
Wilmington, DE 19810-4900

Mailing address

401 Route 73 N BLDG 10, Suite 320
Marlton, NJ 08053
Phone (856) 872-7055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20180321001354 DE Practitioner - Pediatric Medicine 7113140989 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0012077DEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Jan 1, 2018 Accepting new patients
The Nemours Foundation CurrentSince Jan 1, 2018 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

701 N Clayton St
Ste 400
Wilmington, DE 19805
Phone (302) 421-9700

Interoperability endpoints

  • Direct secure messaging: jorge.jarakudin@advocaredoctors.eclinicaldirectplus.com

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1376962936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N BLDG 10, SUITE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-872-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 SILVERSIDE RD STE 1F",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104900",
            "telephone_number": "302-478-2613",
            "fax_number": "302-421-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARA KUDIN",
        "first_name": "JORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DE",
            "license": "C1-0012077",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C1-0012077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.