Individual provider Active NPI

David Bruce Kudrow, MD

  • Neurology Physician
  • Santa Moncia, CA
National Provider Identifier
1952407488
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G62166 Issued in CA
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

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
G62166CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David Kudrow MD Neurology PastSince Apr 1, 1998 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

Verify at the official NPI Registry.