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SAMUEL BENJAMIN RUDNICK
NPI 1407558737
Pediatrics in Los Angeles, CA

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: October 25, 2026.

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

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, maintains a secondary practice location in Los Angeles, 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
Open in Google Maps ↗

Secondary Practice Location 1

Location 1757 Westwood PlzLos Angeles, CA 90095-8358 · Phone (310) 825-9111

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Samuel Rudnick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Uc Regents
Same address
Pediatrics
200 UCLA MEDICAL PLAZA, SUITE 265
Los Angeles, CA 90095
  • Reassigned Medicare billing, California enrollment
  • 323 clinicians in this Medicare group
NPI 1982667663 (310) 825-0867
Venice Family Clinic
3.0 mi
Federally Qualified Health Center (FQHC)
2509 PICO BLVD
Santa Monica, CA 90405
  • Reassigned Medicare billing, California enrollment
  • 147 clinicians in this Medicare group
NPI 1558397067 (310) 392-8636

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
TALIN BABIKIAN PHD
Psychologist (Clinical)
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
DR. RISHMA CHAND M.D.
Pediatrics (Pediatric Critical Care Medicine)
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
DR. ELLEN MILLER CAMPBELL MD
Pediatrics
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
EMMA DOROTHY BURDEKIN
Pediatrics
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
SARA RICHARDS MD
Pediatrics
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
SUKSHMA REDDY SREEPATHI M.D.
Pediatrics (Neonatal-Perinatal Medicine)
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-0867
DR. CHRISTIAN STUART MCEVOY MD, MPH
Surgery (Pediatric Surgery)
200 UCLA MEDICAL PLZ STE 265
LOS ANGELES, CA 90095
Los Angeles County (310) 825-5904

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Samuel Rudnick located?

Samuel Rudnick practices at 200 Ucla Medical Plz Ste 265, Los Angeles, CA 90095. The listed phone number is (310) 825-0867.

What is Samuel Rudnick's specialty?

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

Is Samuel Rudnick enrolled in Medicare?

Yes. Samuel Rudnick is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Samuel Rudnick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Rudnick reassigns Medicare benefits to 2 organizations: Uc Regents (Los Angeles, CA) and Venice Family Clinic (Santa Monica, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Rudnick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 3 months 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.