Jason Ross Rudman

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

2019016866 Issued in MO

Practice address

3009 N Ballas Rd Ste 380C
Saint Louis, MO 63131

Phone

(314) 996-4790

Fax

(314) 996-4792

NPI assigned

Mar 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Otolaryngology

Education

University of Miami, LM Miller School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• Missouri Baptist Sullivan Hospital Hospital, Sullivan, MO, CCN 261337
• Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrudman1056993@direct.carenet.org

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  Medicare reassignment Care Compare group NPD
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD

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

• Barnes Jewish West County Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1831107895
  Care Compare affiliation
• Missouri Baptist Hospital of Sullivan

  • Critical Access Hospital
  • Sullivan, MO
  • NPI 1295743169
  Care Compare affiliation
• Missouri Baptist Hospital of Sullivan

  • Ambulance
  • Sullivan, MO
  • NPI 1831343268

  Hospital

  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1487072229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 380C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312324",
            "telephone_number": "314-996-4790",
            "fax_number": "314-996-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 380C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-996-4790",
            "fax_number": "314-996-4792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "561-715-3607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDMAN",
        "first_name": "JASON",
        "middle_name": "ROSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-30",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2019016866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3009 N Ballas Rd Ste 380C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter Mitchell Ruderman, M.S.W.
• Katherine Nicole Rudisill
• Erica Lynn Rudloff, WHNP
• James Robert Rudloff, MD
• Mary A. Rudloff, M.D.
• Michelle Diane Rudman, MD PHD
• Caroline M Rudnick, MD
• David A Rudnick, MD
• Alexander Rudoi, MD
• Mindy Rudolf, RN, NNP-BC

• Otolaryngology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Otolaryngology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.