NPIMap

Individual provider Active NPI

Siddharth Kudav, M.D.

  • Surgery Physician
  • Somerset, NJ
National Provider Identifier
1720373855
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA10525900 Issued in NJ
Practice address
81 Veronica Ave Ste 205
Somerset, NJ 08873-3491
Phone
(732) 640-5316
NPI assigned
Jun 16, 2011
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2011016892 MO
Surgery Physician 208600000X 25MA10525900 NJ Primary

Addresses

Primary practice location

81 Veronica Ave Ste 205
Somerset, NJ 08873-3491

Mailing address

81 Veronica Ave Ste 205
Somerset, NJ 08873-3491
Phone (732) 640-5316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20211103000845 VA Practitioner - General Surgery 8527202902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Northeastern Ohio University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians

Practice addresses (Care Compare)

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222

5818 Harbour View Blvd
Suffolk, VA 23435-3315

5838 Harbour View Blvd
Suffolk, VA 23435-2663

828 Healthy Way
Suite 220B
Virginia Beach, VA 23462-7958
Phone (757) 483-3030

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux34
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011016892MOMDSurgery Physician
25MA10525900NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Nov 21, 2021 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Surgery CurrentSince Nov 21, 2021 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

155 Kingsley Ln
Ste 405
Norfolk, VA 23505
Phone (757) 278-2220

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

5838 Harbour View Blvd
Ste 240
Suffolk, VA 23435
Phone (757) 278-2220

828 Healthy Way
Ste 220B
Virginia Beach, VA 23462
Phone (757) 673-5860

Interoperability endpoints

  • Direct secure messaging: skudav1152851@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1720373855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 VERONICA AVE STE 205",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733491",
            "telephone_number": "732-640-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 VERONICA AVE STE 205",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733491",
            "telephone_number": "732-640-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDAV",
        "first_name": "SIDDHARTH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2011016892",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA10525900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.