Individual provider Active NPI

Kathryn M Rudman, MD

  • Pediatrics Physician
  • Sandwich, MA
National Provider Identifier
1497718035
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
158388 Issued in MA
Practice address
68B Route 6a
Sandwich, MA 02563-1864
Phone
(508) 833-0269
Fax
(508) 833-1467
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 158388 MA Primary

Addresses

Primary practice location

68B Route 6a
Sandwich, MA 02563-1864

Mailing address

68B Route 6a
Sandwich, MA 02563-1864
Phone (508) 362-5727

Other practice location 1

179 Route 6A
Yarmouth Port, MA 02675-1714
Phone (508) 362-5727

Other identifiers 3

IdentifierTypeStateIssuer
J21057OtherMABCBS
3196631MedicaidMA
202098OtherMAHPHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040712000525 MA Practitioner - Pediatric Medicine 0345228771 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158388MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Jul 22, 2010 Accepting new patients
Medical Affiliates of Cape Cod, Inc. Pediatrics CurrentSince Jul 22, 2010 Accepting new patients
Physicians of Cape Cod Hospital CurrentSince Aug 1, 2012 Accepting new patients
Briarpatch Pediatrics Pediatrics Past Accepting new patients

Locations

27 Park St
#2
Hyannis, MA 02601
Phone (508) 862-5891

140 Yarmouth Rd
Hyannis, MA 02601
Phone (508) 775-6131

25 Communication Way
Hyannis, MA 02601
Phone (508) 957-8669

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

150 Ansel Hallet Rd
West Yarmouth, MA 02673
Phone (508) 771-8350

Interoperability endpoints

  • Direct secure messaging: krudman34007@direct.chppoc.masshiway.net

Organizations & group practices 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1497718035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68B ROUTE 6A",
            "city": "SANDWICH",
            "state": "MA",
            "postal_code": "025631864",
            "telephone_number": "508-362-5727",
            "fax_number": "508-362-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68B ROUTE 6A",
            "city": "SANDWICH",
            "state": "MA",
            "postal_code": "025631864",
            "telephone_number": "508-833-0269",
            "fax_number": "508-833-1467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "179 Route 6A",
            "address_purpose": "LOCATION",
            "city": "Yarmouth Port",
            "state": "MA",
            "postal_code": "026751714",
            "country_code": "US",
            "telephone_number": "508-362-5727",
            "fax_number": "508-362-5722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDMAN",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "158388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J21057",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3196631",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "202098",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandwich, MA

Sources for this page

Verify at the official NPI Registry.