Kadia Mary Bundu, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

D77887 Issued in MD

Practice address

14760 Main Street
Suite 301
Upper Marlboro, MD 20772

Phone

(301) 952-1370

Fax

(301) 952-1372

NPI assigned

Oct 26, 2010

Last updated

Jan 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD, CA2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia and Analgesia Medical Group IncGroup PAC ID 1153316112, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbundu1144612@direct.trinity-health.org

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.

• Anesthesia & Analgesia Medical Group, Inc.

  • Anesthesiology Physician
  • Santa Rosa, CA
  • NPI 1659320984
  Medicare reassignment Care Compare group NPD
• Johns Hopkins University

  dba Jhu - Anesthesia Pain MGMT

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  Medicare reassignment NPD
• Johns Hopkins University

  dba JHU - 4692 Millennium Drive - Physician

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Norcal Healthconnect LLC

  dba Petaluma Valley Hospital

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1467752394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14760 MAIN STREET",
            "address_2": "SUITE 301",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "301-952-1370",
            "fax_number": "301-952-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14760 MAIN STREET",
            "address_2": "SUITE 301",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "301-952-1370",
            "fax_number": "301-952-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDU",
        "first_name": "KADIA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D77887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1221 Mercantile Ln",
            "city": "Largo",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207745374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Building Blocks Healthcare Network LLC (Bbhcn)
• Building Bridges ABA Services LLC
• Building Bridges Therapies, LLC
• Amaya Bullock
• Fatmata Bundu
• Gifter N Bungwa
• Jacob Buro
• Summer Burris, BEHAVIOR TECHNICIAN
• Staci Burrough
• Kimberly Renett Burton

• Anesthesiology Physician in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.