Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMUEL BENJAMIN RUDNICK
NPI 1407558737
Pediatrics in Los Angeles, CA

Q: What is Samuel Rudnick's NPI number?

The NPI number for Samuel Rudnick is 1407558737. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Samuel Rudnick's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Rudnick was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 20, 2023PECOS Enrolled

200 UCLA MEDICAL PLZ STE 265, LOS ANGELES, CA 90095(310) 825-0867(310) 794-5066 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 8, 2026, Apr 23, 2026, Mar 20, 2023 (3 updates tracked since 2023).

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About Samuel Benjamin Rudnick NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL BENJAMIN RUDNICK (NPI 1407558737) is an individual pediatrics provider in Los Angeles, California, licensed in California (A206679) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (2023).

NPPES Registry Identity

NPI1407558737

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameSAMUEL BENJAMIN RUDNICK

Location Address200 UCLA MEDICAL PLZ STE 265Los Angeles, CA 90095-8344

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631

Phone(310) 825-0867

Fax(310) 794-5066

Sole ProprietorYes

Medical School CMSSaint Louis University School Of MedicineGraduated 2023

Enumeration DateMarch 20, 2023

Last NPPES UpdateJuly 8, 20263 updates tracked since enumeration

NPPES CertifiedJuly 8, 2026

✔ NPI 1407558737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · A206679

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

200 UCLA MEDICAL PLZ STE 265, Los Angeles, CA 90095

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Benjamin Rudnick is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133691389

PECOS Enrollment IDI20260701004910

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90095 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL R RECTO MD

Pediatrics (Pediatric Cardiology)