Active NPI
Stephen James Rudolph, MD
- Gastroenterology Physician
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 45608
- Practice address
- 2550 University Ave W
Suite 423 South
Saint Paul, MN 55114-1052 - Phone
- (612) 817-1145
- Fax
- (651) 641-0556
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 45608 | MN | Primary |
Addresses
Primary practice location
2550 University Ave W
Suite 423 South
Saint Paul, MN 55114-1052
Mailing address
PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- University of Minnesota Medical School, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10150 Niagara LN N
Suite 210
Maple Grove, MN 55369-7588
Phone (612) 871-1145
15700 37TH Ave N
Plymouth, MN 55446-3399
Phone (612) 871-1145
15700 37TH Ave N
Suite 300
Plymouth, MN 55446-3661
Phone (612) 871-1145
201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (612) 892-2121
3001 Broadway St NE
B700
Minneapolis, MN 55413-2195
Phone (612) 871-1145
3001 Broadway St NE
Suite 500
Minneapolis, MN 55413-2197
Phone (612) 871-1145
5705 W Old Shakopee Rd
Suite 150
Bloomington, MN 55437-3126
Phone (612) 871-1145
6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000
800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-4633
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 86 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 85 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mngi Digestive Health, P.a. | Gastroenterology | Current | Accepting new patients |
| Affiliated Endoscopy Centers, LLC | Past | Accepting new patients | |
| Community Anesthesia Professionals PLLC | Past | Accepting new patients |
Locations
5705 W Old Shakopee Rd
Ste 150
Bloomington, MN 55437
Phone (612) 870-5530
1185 Town Centre Dr
Ste 205
Eagan, MN 55123
6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477
15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008
15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- stephen.rudolphmd.p1@direct.mngastro.nextgenshare.com
Organizations & group practices 3
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.
-
- Gastroenterology Physician
- Minneapolis, MN
- NPI 1609804541
-
- Ambulatory Surgical Clinic/Center
- Vadnais Heights, MN
- NPI 1518995513
-
- Anesthesiology Physician
- St Paul, MN
- NPI 1083079750
Hospital & facility affiliations 28
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1205970258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14909",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554140909",
"telephone_number": "612-871-1145",
"fax_number": "651-641-0556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 UNIVERSITY AVE W",
"address_2": "SUITE 423 SOUTH",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141052",
"telephone_number": "612-817-1145",
"fax_number": "651-641-0556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "STEPHEN",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MN",
"license": "45608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.