Individual provider Active NPI

Janine Arlene Rudnitski, APRN, CNP

  • Family Nurse Practitioner
  • Sartell, MN
National Provider Identifier
1619600426
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9319 Issued in MN
Practice address
251 County Road 120
Sartell, MN 56303-4872
Phone
(320) 202-8949
Fax
(320) 257-1733
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 1342107 MN
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 9319 MN Primary

Addresses

Primary practice location

251 County Road 120
Sartell, MN 56303-4872

Mailing address

3251 85TH Ave NE
Sauk Rapids, MN 56379-9807
Phone (320) 761-9018

Other identifiers 1

IdentifierTypeStateIssuer
9319OtherMNSTATE OF MINNESOTA BOARD OF NURSING

Other names 1

  • Janine Arlene Rudolph Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL centracare.com Direct CentraCare Clinic

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221012003595 MN Practitioner - Nurse Practitioner 0143696344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

2000 23Rd St S
Sartell, MN 56377-4765
Phone (320) 202-8949

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1342107MNMDNeonatal Intensive Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Single Specialty Current Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2022 Accepting new patients
Centracare Clinic Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
Centracare Clinic Single Specialty Past Accepting new patients
Centracare Clinic Single Specialty Past Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

251 County Road 120
Sartell, MN 56303
Phone (320) 202-8949

Interoperability endpoints

  • Direct secure messaging: jrudnitski645308@direct.centracare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1619600426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 85TH AVE NE",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563799807",
            "telephone_number": "320-761-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 COUNTY ROAD 120",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563034872",
            "telephone_number": "320-202-8949",
            "fax_number": "320-257-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNITSKI",
        "first_name": "JANINE",
        "middle_name": "ARLENE",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MN",
            "license": "1342107",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MINNESOTA BOARD OF NURSING",
            "identifier": "9319",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "centracare.com",
            "affiliation": "Y",
            "endpointDescription": "work",
            "affiliationName": "CentraCare Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIE",
            "address_1": "251 County Road 120",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563034872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JANINE",
            "last_name": "RUDOLPH",
            "middle_name": "ARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.