Robert Lawrence Rudin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD042968E Issued in PA

Practice address

1553 Chester Pike Ste 101
Crum Lynne, PA 19022-1022

Phone

(610) 690-4485

Fax

(610) 876-9741

NPI assigned

Jun 3, 2006

Last updated

Jul 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Psychiatry Physician
  • Chester, PA
  • NPI 1700231297
  NPD
• Prospect Health Access Network, Inc.

  • Gynecologic Oncology Physician
  • Chester, PA
  • NPI 1134574775
  NPD (past)
• CMG Medical Group I LLC

  • Family Medicine Physician
  • Manalapan, NJ
  • NPI 1942778014
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1720026537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 WILLIAMSTOWN RD STE A",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811800",
            "telephone_number": "856-728-1181",
            "fax_number": "856-728-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 CHESTER PIKE STE 101",
            "city": "CRUM LYNNE",
            "state": "PA",
            "postal_code": "190221022",
            "telephone_number": "610-690-4485",
            "fax_number": "610-876-9741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Reeceville Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Coatesville",
            "state": "PA",
            "postal_code": "193201572",
            "country_code": "US",
            "telephone_number": "610-384-5110",
            "fax_number": "610-594-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 Reeceville Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Coatesville",
            "state": "PA",
            "postal_code": "193201572",
            "country_code": "US",
            "telephone_number": "610-384-5110",
            "fax_number": "610-594-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "524 Williamstown Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Sicklerville",
            "state": "NJ",
            "postal_code": "08081",
            "country_code": "US",
            "telephone_number": "856-728-1181",
            "fax_number": "856-728-1182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDIN",
        "first_name": "ROBERT",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD042968E",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09512100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Petrongolo
• Prospect Health Access Network, Inc.
• Ashish V Rana, MD
• Ridley Crossings Surgical Center
• Ronald Andrew Rose, DDS
• S M Vauclain Fire Company
• Michael E Srulevich, DO
• Peter Gore Stein, MD
• Joel S. Tumberello, C.R.N.P.
• Angela Christine Weisengoff

• Internal Medicine Physician in Crum Lynne, PA
• Providers in Crum Lynne, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.