Susan M Rudberg, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33631 Issued in MN

Practice address

3605 Mayfair Ave
Hibbing, MN 55746-2923

Phone

(218) 262-3441

NPI assigned

Apr 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Susan R Moyer Former name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Range Regional Health Services

  dba North Star Hospice

  • Community Based Hospice Care Agency
  • Hibbing, MN
  • NPI 1427036169

  Corporate Director

  CMS ownership

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.

• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment NPD
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  NPD
• Range Regional Health Services

  dba HealthLine Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1326002346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 MAYFAIR AVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462923",
            "telephone_number": "218-262-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 MAYFAIR AVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462923",
            "telephone_number": "218-262-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDBERG",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "33631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "MOYER",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven John Rodriques
• Julie Ann Roppe-Stern, MSW, LICSW
• Warren Ross, OTR/L,CLT
• Terri Rowlan
• Richard Jon Rudberg, M.D.
• Tara Marie Ruud, PA-C
• Eric Saksa, O.D.
• Katie Jo Christine Saletel, APRN, CNP
• Jennifer Salminen
• Brendan Scott Salo, PHARM.D.

• Family Medicine Physician in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.