Kenneth Gerald Nudo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

095532 Issued in NY

Practice address

1659 Cranberry Pond TRL
Victor, NY 14564-9175

Phone

(585) 742-1097

NPI assigned

Feb 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912032517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 CRANBERRY POND TRL",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649175",
            "telephone_number": "585-742-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 CRANBERRY POND TRL",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649175",
            "telephone_number": "585-742-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUDO",
        "first_name": "KENNETH",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "095532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Newton, LMT
• My Lien Nguyen, PHARM.D., PH.D.
• Elizabeth Nicholson, M.S. CCC-SLP/L
• Natalie Olivia Nordlund
• Elizabeth Emaleo Nottingham, MS, CCC-SLP
• Kaitlyn O'Brien
• Margaret Ann O'Brien
• Allysyn Marie O'Connell, PHYSICAL THERAPIST
• Jessica O'Neill
• Thomas Anthony Obrochta

• Internal Medicine Physician in Victor, NY
• Providers in Victor, 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 Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.