NPIMap

Individual provider Active NPI

Michael Rudolph, M.D.

  • Family Medicine Physician
  • Westminster, CO
National Provider Identifier
1972997161
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57855 Issued in CO
Practice address
14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone
(720) 627-4073
Fax
(720) 627-0173
NPI assigned
Mar 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57855 CO Primary

Addresses

Primary practice location

14300 Orchard Pkwy
Westminster, CO 80023-9206

Mailing address

14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone (720) 627-4073

Other practice location 1

13001 E 17th Pl
Aurora, CO 80045-2570
Phone (303) 788-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180703002037 CO Practitioner - Family Practice 2062726201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

14300 Orchard Pkwy
Westminster, CO 80023-9206
Phone (720) 627-0207

14300 Orchard Pkwy Floor 2 Pod
1 Ornh Pain Specialists
Westminster, CO 80023-9206
Phone (303) 661-4100

2551 W 84TH Ave
Westminster, CO 80031-3807

4075 E 128TH Ave
Thornton, CO 80241-2201

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

  • Centura Health-St Anthony North Health Campus Hospital, Westminster, CO, CCN 060104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57855COMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2018 Accepting new patients
Catholic Health Iniatives Colorado Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

4075 E 128th Ave
Thornton, CO 80241
Phone (303) 925-4210

2551 W 84th Ave
Ste 2
Westminster, CO 80031

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Interoperability endpoints

  • Direct secure messaging: michael.rudolph.1@18112.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1972997161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 ORCHARD PKWY",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239206",
            "telephone_number": "720-627-4073",
            "fax_number": "720-627-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 ORCHARD PKWY",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239206",
            "telephone_number": "720-627-4073",
            "fax_number": "720-627-0173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E 17th Pl",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "303-788-3150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "57855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.