Individual provider Active NPI

Andrew Rudawsky, MS, PT, ATC

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1083645691
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J10000682 Issued in DE
Practice address
101 Garden of Eden Rd
Wilmington, DE 19803-1511
Phone
(302) 477-1536
Fax
(302) 477-1564
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J10000682 DE Primary

Addresses

Primary practice location

101 Garden of Eden Rd
Wilmington, DE 19803-1511

Mailing address

23924 Sunny Cove CT
Lewes, DE 19958-5695
Phone (302) 381-8348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000170 DE Practitioner - Physical Therapist in Private Practice 8729156179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite PT LLCGroup PAC ID 7315032711, 17 clinicians

Practice addresses (Care Compare)

1 Righter Pkwy
Suite 150
Wilmington, DE 19803-1510
Phone (302) 477-1536

100 Fitness Way
Hockessin, DE 19707-2423
Phone (302) 234-1030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Elite PT LLC Physical Therapist CurrentSince Apr 1, 2008 Accepting new patients
Elite PT LLC Physical Therapist Current Accepting new patients
Elite PT LLC CurrentSince Apr 1, 2008 Accepting new patients
Christiana Care Health Initiatives Past Accepting new patients
Elite PT, LLC Physical Therapist Past Accepting new patients
Christiana Care Health Initiatives, Inc Physical Therapist Past Accepting new patients

Locations

100 Fitness Way
Hockessin, DE 19707
Phone (302) 234-1030

1 Grenoble Pl
Rehoboth Beach, DE 19971
Phone (302) 226-2691

1 Righter Pkwy
Ste 150
Wilmington, DE 19803
Phone (302) 317-2747

101 Garden of Eden Rd
Wilmington, DE 19803
Phone (302) 477-1536

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1083645691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23924 SUNNY COVE CT",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199585695",
            "telephone_number": "302-381-8348",
            "fax_number": "302-947-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GARDEN OF EDEN RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198031511",
            "telephone_number": "302-477-1536",
            "fax_number": "302-477-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDAWSKY",
        "first_name": "ANDREW",
        "credential": "MS, PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10000682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.