Kudos Medical PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

209777 Issued in NY

Legal business name

KUDOS MEDICAL PLLC

Practice address

304 Genesee St
Chittenango, NY 13037-1707

Phone

(315) 687-6467

Fax

(315) 251-2240

NPI assigned

Jan 3, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ifechukwude Ojugbeli, MDNPI 1710059530

Title

Owner

Phone

(315) 687-6467

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ifechukwude Onyeoba Ojugbeli, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Chittenango, NY
  • NPI 1710059530
  Medicare reassignment Care Compare group NPD Authorized official
• Roberta Countryman, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
  • NPI 1295441640
  Medicare reassignment Care Compare group NPD
• Jessica Dlugolecki, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Chittenango, NY
  • NPI 1841867603

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Midzy B Lysius, NP

  • Nurse Practitioner
  • Syracuse, NY
  • NPI 1174995658
  Medicare reassignment Care Compare group NPD
• James P Riccelli, PT., ECS, CERT MDT

  • Clinical Electrophysiology Physical Therapist
  • E Syracuse, NY
  • NPI 1417927682
  Medicare reassignment Care Compare group NPD
• Nancy Helen Gaskill, PA

  • Medical Physician Assistant
  • Chittenango, NY
  • NPI 1437171964
  Medicare reassignment
• Teresa Jenkins, ANP

  • Adult Health Nurse Practitioner
  • De Witt, NY
  • NPI 1285727560
  NPD (past)
• Erin Katherine Skelly, RPA-C

  • Physician Assistant
  • De Witt, NY
  • NPI 1518276682
  NPD (past)

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1801303532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 GENESEE ST",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130371707",
            "telephone_number": "315-687-6467",
            "fax_number": "315-251-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 GENESEE ST",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130371707",
            "telephone_number": "315-687-6467",
            "fax_number": "315-251-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 Erie Blvd E",
            "address_purpose": "LOCATION",
            "city": "DE Witt",
            "state": "NY",
            "postal_code": "132142227",
            "country_code": "US",
            "telephone_number": "315-251-2244",
            "fax_number": "315-251-2240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KUDOS MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "OJUGBELI",
        "authorized_official_first_name": "IFECHUKWUDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-687-6467",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "209777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Jackson
• Tiffany Nicole Jackson, LMHC
• Whitney King
• Daniel G Kingsley, PT, OCS, COMT, CSCS
• KPH Healthcare Services, Inc. (Kinney Drugs #46)
• Erika C Lambert, MD
• Sean Laubenstein, DPT
• Cara E Lavier, FNP
• Samantha Guarrera Lawrence, DPT
• Vianna Marie Lawrence, PHARMD

• Internal Medicine Physician in Chittenango, NY
• Providers in Chittenango, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.