NPIMap

Individual provider Active NPI

Jason W. Rudolph, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Bethlehem, PA
National Provider Identifier
1023052446
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
MD067886L Issued in PA
Practice address
2775 Schoenersville Rd
Bethlehem, PA 18017-7307
Phone
(610) 861-8080
Fax
(610) 997-5762
NPI assigned
Jun 15, 2006
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD067886L PA
Orthopaedic Surgery Physician 207X00000X MD067886L PA
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X MD067886L PA Primary

Addresses

Primary practice location

2775 Schoenersville Rd
Bethlehem, PA 18017-7307

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 1

IdentifierTypeStateIssuer
0017598980001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000668 PA Practitioner - Orthopedic Surgery 3678583630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

320 W Pumping Station Rd
Suite 3 LVPG Express Care Richland Twnshp
Quakertown, PA 18951-2726
Phone (215) 529-4240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD067886LPAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 17, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 17, 2022 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 20, 2021 Accepting new patients
Hazleton Professional Services CurrentSince Sep 20, 2021 Accepting new patients
Easton Orthopaedic Group Specialist PastSince Jun 9, 2003 Accepting new patients

Locations

2775 Schoenersville Rd
Bethlehem, PA 18017

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

26 Station Cir
Hazleton, PA 18202
Phone (570) 861-8710

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

320 W Pumping Station Rd
Ste 3
Quakertown, PA 18951
Phone (215) 529-4240

Interoperability endpoints

  • Direct secure messaging: jrudolph113111@direct2.lvhn.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1023052446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177307",
            "telephone_number": "610-861-8080",
            "fax_number": "610-997-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "JASON",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD067886L",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD067886L",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "PA",
            "license": "MD067886L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017598980001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.