Active NPI
Jennifer Lynn Kudelko, D.O.
- Internal Medicine Physician
- Largo, FL
National Provider Identifier
1922097955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OS9229
- Practice address
- 13644 Walsingham Rd
Largo, FL 33774-3532 - Phone
- (727) 595-2519
- Fax
- (727) 595-3872
- NPI assigned
- Oct 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS9229 | FL | Primary |
Addresses
Primary practice location
13644 Walsingham Rd
Largo, FL 33774-3532
Mailing address
13644 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 595-2519
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 591273247 | Other | UHC EMPIRE PLAN | |
| 810603 | Other | MAIL HANDLERS BENEFIT PLAN (MHBP) | |
| 2562320 | Other | FL | UNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS |
| 29502 | Other | FL | BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE |
| 29502 | Other | FL | OUT OF STATE BLUE CROSS BLUE SHIELD |
| 298652 | Other | FL | AVMED |
| 8005755 | Other | FL | CIGNA PPO/HMO, OPEN ACCESS, AND GREATWEST |
| 29502 | Other | FL | BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
13644 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 595-2519
Hospital & facility affiliations
- Aspire Home Care
- Baycare Home Care Inc
- Aveanna Home Health
- Morton Plant Hospital
- HCA Florida Largo Hospital
- St Josephs Hospital
- Oak Manor Healthcare & Rehabilitation Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS9229 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suncoast Internal Medicine Consultants, P.a. | Internal Medicine | Current | Accepting new patients |
Locations
13644 Washington Rd
Largo, FL 33774
Phone (727) 595-2519
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Largo, FL
- NPI 1710031984
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Clearwater, FL
- NPI 1144621806
-
- Home Health Agency
- Largo, FL
- NPI 1033117007
-
- General Acute Care Hospital
- Largo, FL
- NPI 1144274879
-
- General Acute Care Hospital
- Clearwater, FL
- NPI 1376529743
-
- Home Health Agency
- Palm Harbor, FL
- NPI 1477853448
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1922097955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13644 WALSINGHAM RD",
"city": "LARGO",
"state": "FL",
"postal_code": "337743532",
"telephone_number": "727-595-2519",
"fax_number": "727-595-3872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13644 WALSINGHAM RD",
"city": "LARGO",
"state": "FL",
"postal_code": "337743532",
"telephone_number": "727-595-2519",
"fax_number": "727-595-3872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUDELKO",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-21",
"last_updated": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "OS9229",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC EMPIRE PLAN",
"identifier": "591273247",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIL HANDLERS BENEFIT PLAN (MHBP)",
"identifier": "810603",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS",
"identifier": "2562320",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE",
"identifier": "29502",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OUT OF STATE BLUE CROSS BLUE SHIELD",
"identifier": "29502",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "298652",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PPO/HMO, OPEN ACCESS, AND GREATWEST",
"identifier": "8005755",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS",
"identifier": "29502",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.
- 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.