NPIMap

Individual provider Active NPI

Jeffrey David Rudie, MD PHD

  • Diagnostic Radiology Physician
  • San Francisco, CA
National Provider Identifier
1124435342
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A159716 Issued in CA
Practice address
505 Parnassus Ave
San Francisco, CA 94143-2204
Phone
(858) 220-6380
NPI assigned
Jul 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Diagnostic Radiology Physician 2085R0202X A159716 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143-2204

Mailing address

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (858) 220-6380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200707003143 CA Practitioner - Diagnostic Radiology 7810310067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Geffen School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A159716CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Jul 4, 2021 Accepting new patients
Scripps Health Family Medicine Current Accepting new patients
Scripps Health Family Medicine CurrentSince Jul 4, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1124435342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "858-220-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "858-220-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDIE",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A159716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.