Active NPI
Ehren Rudolph, M.D., PH.D
- Surgery Physician
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 56702
- Practice address
- 640 Jackson St
Saint Paul, MN 55101-2502 - Phone
- (651) 254-5151
- Fax
- (651) 254-4123
- NPI assigned
- Apr 20, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgical Critical Care Physician | 2086S0102X | 56702 | MN | |
| Surgery Physician | 208600000X | 56702 | MN | Primary |
Addresses
Primary practice location
640 Jackson St
Saint Paul, MN 55101-2502
Mailing address
420 Delaware St SE
Minneapolis, MN 55455-0341
Phone (612) 625-3926
Other practice location 1
420 Delaware St SE
Minneapolis, MN 55455-0341
Phone (612) 625-3926
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- University of Wisconsin School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400
3366 Oakdale Ave N
Suite 200
Robbinsdale, MN 55422-2962
Phone (763) 520-5200
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56702 | MN | MD | Surgical Critical Care Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Surgery | Current | Accepting new patients |
| Fairview Health Services | Current | Accepting new patients | |
| North Memorial Health Care | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| North Memorial Health Care | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients |
Locations
303 E Nicollet Blvd
Ste 300
Burnsville, MN 55337
Phone (952) 435-4140
6405 France Ave S
Ste 440
Edina, MN 55435
Phone (952) 927-7004
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463
420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
3366 Oakdale Ave N
Ste 200
Robbinsdale, MN 55422
Phone (763) 287-5000
640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164
Organizations & group practices 8
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.
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
-
dba HealthPartners Medical Group
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
dba M Health Fairview Surgical Consultants
- Surgery Physician
- Edina, MN
- NPI 1235395864
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
dba Fairview Emergency Medical Services
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
dba HealthPartners Midway Residency Dental
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
-
- Clinic/Center
- Blaine, MN
- NPI 1841995552
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1225272552
-
dba North Memorial Ambulance Service
- Ambulance
- Brooklyn Center, MN
- NPI 1538195912
Hospital
-
dba North Memorial Health Specialty Center - Robbinsdale
- Medical Specialty Clinic/Center
- Robbinsdale, MN
- NPI 1699953000
Hospital
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
-
- General Acute Care Hospital
- Waconia, MN
- NPI 1275608457
-
- General Acute Care Hospital
- Chaska, MN
- NPI 1710748538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1952628604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550341",
"telephone_number": "612-625-3926",
"fax_number": "612-625-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 JACKSON ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551012502",
"telephone_number": "651-254-5151",
"fax_number": "651-254-4123"
}
],
"practiceLocations": [
{
"address_1": "420 Delaware St SE",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554550341",
"country_code": "US",
"telephone_number": "612-625-3926",
"fax_number": "612-625-1717",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUDOLPH",
"first_name": "EHREN",
"name_prefix": "Dr.",
"credential": "M.D., PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-20",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "MN",
"license": "56702",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "56702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.