Active NPI
Hollie C. Rudolph, PA-C
- Physician Assistant
- Newark, DE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C5-0001093
- Practice address
- 4701 Ogletown Stanton Road
Suite 2100
Newark, DE 19713-7000 - Phone
- (302) 623-4530
- Fax
- (302) 623-4578
- NPI assigned
- Oct 4, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C5-0001093 | DE | Primary |
| Physician Assistant | 363A00000X | DE |
Addresses
Primary practice location
4701 Ogletown Stanton Road
Suite 2100
Newark, DE 19713-7000
Mailing address
200 Hygeia Dr Ste 2300
CCHS Physician Contracting
Newark, DE 19713-2049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- 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, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4745 Ogletown Stanton Rd
Newark, DE 19713-2074
Phone (302) 623-7600
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5-0001093 | DE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Health Services Inc | Current | Accepting new patients | |
| Christiana Care Health Services Inc | Current | Accepting new patients | |
| Christiana Care Health Services Inc. | Past | Accepting new patients |
Locations
4701 Ogletown Stanton Rd
Ste 2100
Newark, DE 19713
Phone (302) 623-4530
4755 Ogletown Stanton Rd
Ste 2E70
Newark, DE 19718
Phone (302) 733-3475
4745 Stanton Ogletwn Rd
Newark, DE 19713
Phone (302) 623-7600
200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362
1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440
Organizations & group practices 3
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.
-
- Pulmonary Disease Physician
- Newark, DE
- NPI 1255618070
-
- Neurology Physician
- Chadds Ford, PA
- NPI 1881228484
-
- Pulmonary Disease Physician
- Wilmington, DE
- NPI 1396715736
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lewes, DE
- NPI 1821196486
-
- General Acute Care Hospital
- Wilmington, DE
- NPI 1134194038
-
- General Acute Care Hospital
- Elkton, MD
- NPI 1376523357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482278400000",
"number": "1720538630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HYGEIA DR STE 2300",
"address_2": "CCHS PHYSICIAN CONTRACTING",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 OGLETOWN STANTON ROAD",
"address_2": "SUITE 2100",
"city": "NEWARK",
"state": "DE",
"postal_code": "197137000",
"telephone_number": "302-623-4530",
"fax_number": "302-623-4578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "HOLLIE",
"middle_name": "C.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2016-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DE",
"license": "C5-0001093",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DE",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.