Individual provider Active NPI

Adam D Rudasill, PA-C

  • Physician Assistant
  • Middleburg, PA
National Provider Identifier
1720757149
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Dock Hill Rd
Middleburg, PA 17842-8910
Phone
(570) 837-5889
Fax
(570) 837-6600
NPI assigned
Sep 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA Primary

Addresses

Primary practice location

1 Dock Hill Rd
Middleburg, PA 17842-8910

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211216000986 PA Practitioner - Physician Assistant 9032500517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

1 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-5889

Hospital & facility affiliations

  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC Multi-Specialty CurrentSince Nov 2, 2021 Accepting new patients

Locations

1 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-1740

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 100
Selinsgrove, PA 17870
Phone (570) 743-1703

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

Interoperability endpoints

  • Direct secure messaging: adamrudasillpac@fpc.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1720757149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-5889",
            "fax_number": "570-837-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDASILL",
        "first_name": "ADAM",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, PA

Sources for this page

Verify at the official NPI Registry.