Christopher Kudrich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

012834 Issued in NY

Practice address

1399 Park Ave
New York, NY 10029-4567

Phone

(212) 585-4672

NPI assigned

Oct 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, PA, DC, MD4 enrollments

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 4

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ophelia Medical Group FL, P.a.

  • Addiction Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1588244750

  DC, MD, NY

  Medicare reassignment Care Compare group
• Housing Works Services II, Inc

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1083647101
  Medicare reassignment
• Ophelia Medical Group, P.C.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Philadelphia, PA
  • NPI 1376179150
  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1447403191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 PIERCE AVE",
            "city": "ARCHBALD",
            "state": "PA",
            "postal_code": "184031559",
            "telephone_number": "570-947-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294567",
            "telephone_number": "212-585-4672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2367-69 Second ave",
            "address_purpose": "LOCATION",
            "city": "New York City",
            "state": "NY",
            "postal_code": "10035",
            "country_code": "US",
            "telephone_number": "212-876-2300 x117",
            "fax_number": "212-722-7618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUDRICH",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Kudla
• Anne Kudlacik, ANP
• Peter Kudler, M.D.
• David Kudlowitz, M.D.
• Satoru Kudose, MD
• Ilya Kudrin
• Bria Nicole Kudryk
• Avinash Kudupudi, MD
• Anupa Kudva
• Mark J Kuebel, L.AC.

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.