Active NPI
Nadia Katrina Rudman
- Physician Assistant
- Warwick, RI
National Provider Identifier
1699409003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfax Acne & Dermatology Services, PC | Past | 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.
-
- MOHS-Micrographic Surgery Physician
- East Providence, RI
- NPI 1093439044
-
- Nurse Practitioner
- East Providence, RI
- NPI 1245947332
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.