NPIMap

Individual provider Active NPI

Steven Henry Rudolph, M.D.

  • Vascular Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1659437473
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
135298 Issued in NY
Practice address
3131 Kings Hwy Ste 2-06
Brooklyn, NY 11234-2644
Phone
(718) 677-2089
Fax
(718) 434-0395
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 135298 NY Primary

Addresses

Primary practice location

3131 Kings Hwy Ste 2-06
Brooklyn, NY 11234-2644

Mailing address

3131 Kings Hwy Ste 2-06
Brooklyn, NY 11234-2644
Phone (718) 677-2089

Other identifiers 1

IdentifierTypeStateIssuer
00933326MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729000064 NY Practitioner - Neurology 4688644479 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of New York Downstate Medical Center, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

5 E 98TH St 2ND FL
New York, NY 10029-6501
Phone (212) 241-4572

Hospital & facility affiliations

  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Rudolph, M.D. Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2019 Accepting new patients
Beth Israel Medical Center Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: stevenrudolph@mai.allscriptsdirect.net

Organizations & group practices 6

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 9

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1659437473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 KINGS HWY STE 2-06",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342644",
            "telephone_number": "718-677-2089",
            "fax_number": "718-434-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 KINGS HWY STE 2-06",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342644",
            "telephone_number": "718-677-2089",
            "fax_number": "718-434-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "STEVEN",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NY",
            "license": "135298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00933326",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.