Individual provider Active NPI

Nadia Katrina Rudman

  • Physician Assistant
  • Warwick, RI
National Provider Identifier
1699409003
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1139 Main Ave
Warwick, RI 02886-1940
Phone
(401) 739-6600
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1139 Main Ave
Warwick, RI 02886-1940

Mailing address

588 Longmeadow St
Longmeadow, MA 01106-2212

Other practice location 1

588 Longmeadow St
Longmeadow, MA 01106-2212
Phone (401) 447-2135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20231214002535 RI Practitioner - Physician Assistant 3577912666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Findley Dermatology, LLCGroup PAC ID 7618344508, 4 clinicians

Practice addresses (Care Compare)

1275 Wampanoag Trail
Suite 6
East Providence, RI 02915-1217
Phone (401) 415-8586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Acne & Dermatology Services, PC PastSince Nov 6, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1699409003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 LONGMEADOW ST",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011062212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 MAIN AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861940",
            "telephone_number": "401-739-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "588 Longmeadow St",
            "address_purpose": "LOCATION",
            "city": "Longmeadow",
            "state": "MA",
            "postal_code": "011062212",
            "country_code": "US",
            "telephone_number": "401-447-2135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDMAN",
        "first_name": "NADIA",
        "middle_name": "KATRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.