Hannah Rae Rudolph

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10004442A Issued in IN

Practice address

2800 S State Road 135 Ste 250
Greenwood, IN 46143-6223

Phone

(317) 300-1788

Fax

(317) 743-8103

NPI assigned

Jul 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optima Dermatology LLCGroup PAC ID 3971561648, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: hrudolph@dermindy.emadirect.md

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.

• Optima Dermatology LLC

  • Dermatology Physician
  • Boardman, OH
  • NPI 1831187764

  IN

  Medicare reassignment Care Compare group
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1376214981
  Care Compare affiliation
• Franciscan Health Indianapolis & Mooresville

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1386749893
  Care Compare affiliation

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1003540204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NEW HAMPSHIRE AVE STE 2",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S STATE ROAD 135 STE 250",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436223",
            "telephone_number": "317-300-1788",
            "fax_number": "317-743-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "HANNAH",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004442A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Scott Rowell, PT, DPT
• Frances Rowland, DC
• Aisha Royston
• Donovan Royston
• Sara Ruch
• Richard L. Ruegg, PH.D.
• Allison Rumple, RBT
• Mason Runkle, RBT
• Rachel Lynn Runyon Lortie, OTR/L
• Collin Rush, O.D.

• Physician Assistant in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.