Individual provider Active NPI

Jude Kwame Arthur, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1912096884
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201138 Issued in NY
Practice address
860 Grand Concourse
Suite 1-C
Bronx, NY 10451-2814
Phone
(718) 665-7384
Fax
(718) 665-5335
NPI assigned
Oct 11, 2006
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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 201138 NY Primary

Addresses

Primary practice location

860 Grand Concourse
Suite 1-C
Bronx, NY 10451-2814

Mailing address

860 Grand Concourse
Suite 1-C
Bronx, NY 10451-2814
Phone (718) 665-7384

Other identifiers 1

IdentifierTypeStateIssuer
01719924MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170817000543 NY Practitioner - Pediatric Medicine 4284906827 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201138NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Pediatrics CurrentSince Jul 5, 2017 Accepting new patients
Bronxcare Health System CurrentSince Jul 5, 2017 Accepting new patients
Martha Shih Wong MD Past Accepting new patients

Locations

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1912096884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 GRAND CONCOURSE",
            "address_2": "SUITE 1-C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104512814",
            "telephone_number": "718-665-7384",
            "fax_number": "718-665-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 GRAND CONCOURSE",
            "address_2": "SUITE 1-C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104512814",
            "telephone_number": "718-665-7384",
            "fax_number": "718-665-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARTHUR",
        "first_name": "JUDE",
        "middle_name": "KWAME",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "201138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01719924",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.