Organization Active NPI

Ronald G Kludo DO PA

  • Family Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1972895456
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RONALD G KLUDO DO PA
Practice address
7653 Lkake Worth
Lake Worth, FL 33467
Phone
(561) 434-9066
NPI assigned
May 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Authorized official

Name
Dr. Ronald G Kludo, D.O,NPI 1689725533
Title
Physican
Phone
(561) 434-9066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7653 Lkake Worth
Lake Worth, FL 33467

Mailing address

7653 Lkake Worth
Lake Worth, FL 33467
Phone (561) 434-9066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110517000360 FL Part B Supplier - Clinic/Group Practice 7517143159 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Worth, FL

National Provider Directory

National Provider Directory

Locations

7653 Lake Worth Rd
Lake Worth, FL 33467
Phone (561) 434-9066

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1972895456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7653 LKAKE WORTH",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-434-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7653 LKAKE WORTH",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-434-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD G KLUDO DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "KLUDO",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICAN",
        "authorized_official_telephone_number": "561-434-9066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O,"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.