NPIMap

Individual provider Active NPI

Ashfaq Latif Kudia, MD

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1669482188
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0068850 Issued in FL
Practice address
1301 Plantation Island Dr S Ste 302a
St Augustine, FL 32080-3117
Phone
(904) 461-9330
Fax
(904) 461-9331
NPI assigned
Aug 8, 2006
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0068850 FL Primary

Addresses

Primary practice location

1301 Plantation Island Dr S Ste 302a
St Augustine, FL 32080-3117

Mailing address

1301 Plantation Island Dr S Ste 302a
St Augustine, FL 32080-3117
Phone (904) 461-9330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051015000018 FL Practitioner - Family Practice 8426074873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1301 Plantation Island Dr S
Suite 302a
St Augustine, FL 32080-3117
Phone (904) 461-9330

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as apm
Quality
77.66
Promoting interoperability
70.54
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0068850FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashfaq Kudia, M.D., P.a. CurrentSince Aug 1, 2009 Accepting new patients
Atlantic Family Medical Center of Jacksonville PL Family Medicine Past Accepting new patients

Locations

1301 Plantation Island Dr S
Ste 302A
Saint Augustine, FL 32080
Phone (386) 232-9203

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

Interoperability endpoints

  • Direct secure messaging: akudia741064@direct.shands.ufl.edu
  • Direct secure messaging: ashfaqkudia@akmdpa.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1669482188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 302A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803117",
            "telephone_number": "904-461-9330",
            "fax_number": "904-461-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 302A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803117",
            "telephone_number": "904-461-9330",
            "fax_number": "904-461-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDIA",
        "first_name": "ASHFAQ",
        "middle_name": "LATIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0068850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.