Active NPI
Paul Leonard Kudla, M.D.
- Internal Medicine Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301116901
- Practice address
- 22101 Moross Rd
Professional Building 2, Suite 50
Detroit, MI 48236 - Phone
- (734) 771-3110
- NPI assigned
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301116901 | MI | Primary |
Addresses
Primary practice location
22101 Moross Rd
Professional Building 2, Suite 50
Detroit, MI 48236
Mailing address
22101 Moross Rd
Professional Building 2, Suite 50
Detroit, MI 48236-2148
Phone (313) 343-7774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
19251 Mack Ave
Suite 333
Grosse Pointe Woods, MI 48236-2898
Phone (313) 343-7280
Hospital & facility affiliations
- Henry Ford Home Health Care
- Henry Ford Health St John Hospital
- Henry Ford Health Hospital
- Henry Ford Health Warren Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301116901 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Specialists of Southeast Michigan PC | Current | Accepting new patients | |
| Henry Ford Health St. John Hospital | Internal Medicine | Current | Accepting new patients |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| St. John Hospital | Past | Accepting new patients |
Locations
22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248
22101 Moross Rd
Bldg 2
Detroit, MI 48236
Phone (313) 343-7784
19251 Mack Ave
Ste 333
Grosse Pointe Woods, MI 48236
Phone (313) 343-7280
22201 Moross Rd
Ste 50
Grosse Pointe Woods, MI 48236
Phone (313) 343-7774
Interoperability endpoints
- pkudla373041@direct.hfhs.org
Organizations & group practices 5
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.
-
- Podiatrist
- Harrison Township, MI
- NPI 1043478910
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1912965088
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1023100500
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1649355918
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Warren, MI
- NPI 1124099858
-
- General Acute Care Hospital
- Madison Heights, MI
- NPI 1215139233
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Home Health Agency
- Detroit, MI
- NPI 1932162096
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1477904142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22101 MOROSS RD",
"address_2": "PROFESSIONAL BUILDING 2, SUITE 50",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362148",
"telephone_number": "313-343-7774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22101 MOROSS RD",
"address_2": "PROFESSIONAL BUILDING 2, SUITE 50",
"city": "DETROIT",
"state": "MI",
"postal_code": "48236",
"telephone_number": "734-771-3110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUDLA",
"first_name": "PAUL",
"middle_name": "LEONARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-23",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301116901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.