Adam R Rudolph, MD
Individual provider Active NPI Family Medicine Physician · Petersburg, IN
NPI 1821593369 · NPPES record last updated Sep 13, 2021
Key facts
- NPI
- 1821593369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01086361A (IN)
- Practice address
- 1004 E Illinois St
Petersburg, IN 47567-8068 - Phone
- (812) 354-1052
- Fax
- (812) 354-8280
- NPI assigned
- Mar 27, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Deaconess Clinic Inc
Practice addresses (Care Compare)
1004 E Illinois St
Petersburg, IN 47567-8068
Phone (812) 354-1052
Hospital & facility affiliations
- Preferred Home Health Care, Inc
- Deaconess Home Health, LLC
- Good Samaritan Home Care Services of Vincennes in
- Deaconess Hospital Inc
- Memorial Hospital and Health Care Center
- Gibson General Hospital
- Good Samaritan Hospital
- Daviess Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210813002949 | IN | Practitioner - Family Practice | 2264843234 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Clinic, Inc | Family Medicine | Current |
Accepting new patients |
| Deaconess Clinic Inc | Family Medicine | Current |
Accepting new patients |
| Deaconess Clinic Inc. | Current | Accepting new patients |
Locations
421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645
1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187
1004 E Illinois St
Petersburg, IN 47567
Phone (812) 354-1052
Interoperability endpoints
- arudolph227546@direct.deaconess.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 01086361A | IN | Yes |
Addresses
Primary practice location
1004 E Illinois St
Petersburg, IN 47567-8068
Mailing address
PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815
Other providers in Petersburg, IN
- Pike County Medical Transport LLC
- Pike County School Corp
- Renee Abrassart Ramsey
- Leslie Roberts
- Nicole Leigh Roy
- Justin Rumble
- Stephanie Renee Ruppel
- Amber D Russell
- Gina Schmitt
- Clinton R Shoultz
All providers in Petersburg, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.