ALEXEI KUDLA (NPI# 1538455068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538455068 |
| Entity Type | Individual |
| Full Name | ALEXEI KUDLA |
| Credential | M.D. |
| Practice Address |
330 Brookline Ave Dept Of Boston MA 02215-5400 |
| Mailing Address |
330 Brookline Ave Boston MA 02215-5400 |
| Practice Telephone | 6177549500 |
| Mailing Telephone | 6177549500 |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2019-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
281386 | MA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | A123679 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Naval Medical Ctr, 34800 Bob Wilson Drive, San Diego, CA 921345000 | 6195454359 |
| Street Address |
330 BROOKLINE AVE DEPT OF |
| City | BOSTON |
| State | MA |
| Zip Code | 02215-5400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699095745 | Victoria Marie Derevianko | Anesthesiology | 330 Brookline Ave Dept Of, Boston, MA 02215 | 2010-06-10 |
| 1619506375 | Heba Naseem | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2020-04-05 |
| 1699257774 | Minwook Chong | Nurse Anesthetist, Certified Registered | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2018-09-05 |
| 1417447277 | Ryan Cuerdon | Physician Assistant | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2018-05-16 |
| 1245737808 | Kayleigh Mcdonald | Nurse Anesthetist, Certified Registered | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2018-04-10 |
| 1659872489 | Kevin M Phelan | Registered Nurse | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2018-02-27 |
| 1336662469 | Jasmine Ann Steele | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave Dept Of, Boston, MA 02215-5400 | 2017-07-20 |
| 1801325055 | Fotini Mitsis | Registered Nurse | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2017-06-09 |
| 1053852673 | Catherine E. Reilly | Nurse Anesthetist, Certified Registered | 330 Brookline Ave Dept Of, Boston, MA 02215-5491 | 2017-03-15 |
| 1134575327 | Elizabeth Saffi Heckman | Registered Nurse | 330 Brookline Ave Dept Of, Boston, MA 02215 | 2016-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1538783089 | Yutsz Cherng | Counselor | 870r Commonwealth Avenue, Boston, MA 02215 | 2020-06-01 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1427605278 | Liana Zucco | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 | 2019-08-26 |
| 1831759430 | Brian William Hayes | Radiology | 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 | 2019-06-17 |
| 1396304358 | Elizabeth Hai Yen Du | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 | 2019-06-12 |
| 1922665439 | Corey Shaphard Miller | Student in an Organized Health Care Education/Training Program | 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 | 2019-05-21 |
| Find all providers in zip 02215 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604570 | Yarab Mubarak Habib Al Bulushi | Radiology | 330 Brookline Ave Dept of Radiology, Boston, MA 02215-5400 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1417507740 | Daniel Andres Vargas Zapata | Radiology | 330 Brookline Ave # Es-215, Boston, MA 02215-5491 | 2019-09-18 |
| 1851870992 | Robert Kevin Moreland | Radiology | 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02120 | 2018-08-09 |
| 1790270239 | Rahul Gujrathi | Radiology | 450 Brookline Ave Dana-farber Cancer Institute, Department of Imaging Dl-198, Boston, MA 02215 | 2018-06-27 |
| 1700381282 | Casey Keith Bishop | Radiology | 820 Harrison Ave Dept Of, Boston, MA 02118-2905 | 2018-03-27 |
| 1922517713 | Arwa Alzaghal | Radiology | Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115 | 2017-09-25 |
| 1053838623 | Tyler Michael Coupal | Radiology | 55 Fruit Street, Yawkey 6e, Musculoskeletal Imaging, Massachusetts General Hospital, Boston, MA 02114 | 2017-08-24 |
| 1912439068 | Hamza Rahimi | Radiology | 820 Harrison Ave Fgh Building 3rd Floor, Boston, MA 02118 | 2017-03-29 |
| 1467983106 | Donghoon Derek Shin | Radiology | 820 Harrison Ave # Fgh3022, Boston, MA 02118 | 2017-03-24 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.