Individual provider Active NPI

Gary Rudashevsky, CNP

  • Adult Health Nurse Practitioner
  • Edina, MN
National Provider Identifier
1720298565
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A0407181 Issued in MN
Practice address
6550 York Ave S Ste 211
Edina, MN 55435-2333
Phone
(952) 225-5400
NPI assigned
May 23, 2007
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A0407181 MN Primary

Addresses

Primary practice location

6550 York Ave S Ste 211
Edina, MN 55435-2333

Mailing address

6550 York Ave S Ste 303
Edina, MN 55435-2334
Phone (952) 225-5400

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
I20101029000782 MN Practitioner - Nurse Practitioner 1759575152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
House Calls Consultants PAGroup PAC ID 6800056391, 4 clinicians

Practice addresses (Care Compare)

6550 York Ave S
Suite 211
Edina, MN 55435-2333
Phone (952) 225-5400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1675MNMDChiropractor
A0407181MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Urology Clinic PA PastSince Sep 1, 2017 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1720298565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 303",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352334",
            "telephone_number": "952-225-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 211",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352333",
            "telephone_number": "952-225-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDASHEVSKY",
        "first_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "A0407181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.