Active NPI
David Bruce Kudrow, MD
- Neurology Physician
- Santa Moncia, CA
National Provider Identifier
1952407488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- G62166
- Practice address
- 2001 Santa Monica Blvd
Suite 880W
Santa Moncia, CA 90404-2102 - Phone
- (310) 315-1456
- Fax
- (310) 315-1486
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | G62166 | CA | Primary |
Addresses
Primary practice location
2001 Santa Monica Blvd
Suite 880W
Santa Moncia, CA 90404-2102
Mailing address
2001 Santa Monica Blvd
Suite 880W
Santa Monica, CA 90404-2102
Phone (310) 315-1456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100928000209 | CA | Practitioner - Neurology | 6204952294 | Practice locations: Santa Monica, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2001 Santa Monica Blvd
Suite 880W
Santa Moncia, CA 90404-2102
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G62166 | CA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Kudrow MD | Neurology | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282089600000",
"number": "1952407488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 SANTA MONICA BLVD",
"address_2": "SUITE 880W",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042102",
"telephone_number": "310-315-1456",
"fax_number": "310-315-1486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 SANTA MONICA BLVD",
"address_2": "SUITE 880W",
"city": "SANTA MONCIA",
"state": "CA",
"postal_code": "904042102",
"telephone_number": "310-315-1456",
"fax_number": "310-315-1486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUDROW",
"first_name": "DAVID",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2010-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "G62166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.