Individual provider Active NPI

Jeffrey A Rudolph, M.D.

  • Pediatric Gastroenterology Physician
  • Pittsburgh, PA
National Provider Identifier
1518996107
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
432827 Issued in PA
Practice address
1 Childrens Hospital Dr
4401 Penn Avenue
Pittsburgh, PA 15224-1529
Phone
(412) 692-5180
Fax
(412) 692-7355
NPI assigned
Jul 3, 2006
Last updated
May 9, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 432827 PA Primary

Addresses

Primary practice location

1 Childrens Hospital Dr
4401 Penn Avenue
Pittsburgh, PA 15224-1529

Mailing address

1 Childrens Hospital Dr
4401 Penn Avenue
Pittsburgh, PA 15224-1529
Phone (412) 692-5180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20090929000615 PA Practitioner - Pediatric MedicinePractitioner - Gastroenterology 6608912902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
University of Pittsburgh School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

4401 Penn Ave
Pittsburgh, PA 15224-1334
Phone (412) 692-9513

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
432827PAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Jan 30, 2011 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jan 30, 2011 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Upmc Children's Hospital of Pittsburgh Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1518996107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS HOSPITAL DR",
            "address_2": "4401 PENN AVENUE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241529",
            "telephone_number": "412-692-5180",
            "fax_number": "412-692-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS HOSPITAL DR",
            "address_2": "4401 PENN AVENUE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241529",
            "telephone_number": "412-692-5180",
            "fax_number": "412-692-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "PA",
            "license": "432827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.