Michael Rudoff, D.O.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

02007536A Issued in IN

Practice address

2512 E Dupont Rd Ste 110
Fort Wayne, IN 46825-1609

Phone

(260) 458-3045

Fax

(260) 479-2947

NPI assigned

Jun 27, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Midwestern University, Chicago College of Osteopathic Med, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dupont Hospital LLC Hospital, Fort Wayne, IN, CCN 150150
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133
• Bluffton Regional Medical Center Hospital, Bluffton, IN, CCN 150075
• Dukes Memorial Hospital Hospital, Peru, IN, CCN 151318

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.rudoff@lutheranhealthnetwork.cernerdirect.com

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.

• Lutheran Medical Group LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1164662805
  Medicare reassignment Care Compare group NPD
• Lutheran Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1710275664
  NPD

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

• Bluffton Health System LLC

  • General Acute Care Hospital
  • Bluffton, IN
  • NPI 1376594366
  Care Compare affiliation
• Dukes Health System LLC

  • Critical Access Hospital
  • Peru, IN
  • NPI 1619920949
  Care Compare affiliation
• Dupont Hospital LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1538110556
  Care Compare affiliation
• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Warsaw Health System LLC

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1134570690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 E DUPONT RD STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251609",
            "telephone_number": "260-458-3045",
            "fax_number": "260-479-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOFF",
        "first_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "02007536A",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101022797",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michael.Rudoff@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DM",
            "address_1": "2512 E DuPont Rd Ste 110",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468251609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ruckel, Inc.
• James S Ruckel, DC
• Ruckman Oral Surgery & Implant Center
• Phil Noble Ruckman III, D.D.S.
• Melea Ann Rudig
• James Raymond Rudolph, M.D.
• Rhys Rudolph, M.D.
• Thomas M Ruediger, PT
• Sandra L Ruen, MSW
• Joel A Ruetz, PA-C

• Urology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Urology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.