Individual provider Active NPI

Heather M Rudisill, MD

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1316953433
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00040152 Issued in WA
Practice address
3915 Talbot Rd S
Ste 401
Renton, WA 98055-5738
Phone
(425) 656-4224
Fax
(425) 656-5099
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00040152 WA Primary

Addresses

Primary practice location

3915 Talbot Rd S
Ste 401
Renton, WA 98055-5738

Mailing address

PO Box 34876
Seattle, WA 98124-1876
Phone (425) 656-5412

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100708000833 WA Practitioner - Family Practice 3577694553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

3915 Talbot Rd S
Suite 401
Renton, WA 98055-5738
Phone (425) 656-4224

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Family Medicine CurrentSince May 15, 2010 Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4033 Talbot Rd S
Ste 570
Renton, WA 98055
Phone (425) 656-5400

14410 SE Petrovitsky Rd
Ste 104
Renton, WA 98058
Phone (425) 656-4242

3600 Lind Ave SW
Ste 100
Renton, WA 98057

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

3915 Talbot Rd S
Ste 401
Renton, WA 98055
Phone (425) 656-4224

Interoperability endpoints

  • Direct secure messaging: hrudisill6201@direct.valleymed.org

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.

Hospital & facility affiliations 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1316953433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-656-5412",
            "fax_number": "425-656-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S",
            "address_2": "STE 401",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-656-4224",
            "fax_number": "425-656-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDISILL",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.