Dr John Bradley Rudolph, DO - Medicare Family Practice in Lewiston, ID

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Dr John Bradley Rudolph, DO is a medicare enrolled "Family Medicine" physician in Lewiston, Idaho. He graduated from medical school in 2013 and has 12 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Vannvei Llc, Sound Physicians Of Idaho, Meza Post Acute And Long Term Care Pllc and his current practice location is 415 6th St Ste 3c, Lewiston, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 750-7300.

Dr John Bradley Rudolph is licensed to practice in Idaho (license number O-0990) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1548503022.

Contact Information

Dr John Bradley Rudolph, DO
415 6th St Ste 3c,
Lewiston, ID 83501-2431
(208) 750-7300
(208) 746-4899

Map and Direction




Physician's Profile

Full NameDr John Bradley Rudolph
GenderMale
SpecialityFamily Practice
Experience12 Years
Location415 6th St Ste 3c, Lewiston, Idaho
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr John Bradley Rudolph graduated from medical school in 2013
  NPI Data:
  • NPI Number: 1548503022
  • Provider Enumeration Date: 04/03/2013
  • Last Update Date: 06/18/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1759604309
  • Enrollment ID: I20170116000186

Medical Identifiers

Medical identifiers for Dr John Bradley Rudolph such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548503022NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine OP60506022 (Washington)Secondary
207Q00000XFamily Medicine O-0990 (Idaho)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Elite Home HealthClarkston, WAHome health agency
Elite HospiceClarkston, WAHospice
Tri-state Memorial HospitalClarkston, WAHospital
St Joseph Regional Medical CenterLewiston, IDHospital
Lewiston Transitional Care Of CascadiaLewiston, IDNursing home
Prestige Care & Rehabilitation - ClarkstonClarkston, WANursing home
Royal Plaza Health & RehabilitationLewiston, IDNursing home
Advanced Health Care Of LewistonLewiston, IDNursing home
Life Care Center Of LewistonLewiston, IDNursing home

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Vannvei Llc125474342020
Sound Physicians Of Idaho468870534653
Meza Post Acute And Long Term Care Pllc498102850321

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr John Bradley Rudolph allows following entities to bill medicare on his behalf.
Entity NameTri-state Memorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598814352
PECOS PAC ID: 4082502422
Enrollment ID: O20040911000031
Entity NameSound Physicians Of Idaho
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730407461
PECOS PAC ID: 4688705346
Enrollment ID: O20100624000921
Entity NameSt Joseph Hospital Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205368404
PECOS PAC ID: 8325325806
Enrollment ID: O20170606002496
Entity NameMeza Post Acute And Long Term Care Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932725215
PECOS PAC ID: 4981028503
Enrollment ID: O20200715002977
Entity NameVannvei Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881200517
PECOS PAC ID: 1254743420
Enrollment ID: O20201211000338
Entity NameLiving Legacy Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891487997
PECOS PAC ID: 2163885849
Enrollment ID: O20240118001847

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr John Bradley Rudolph is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr John Bradley Rudolph, DO
625 6th Ave,
Lewiston, ID 83501-2424

Ph: (208) 750-7464		Dr John Bradley Rudolph, DO
415 6th St Ste 3c,
Lewiston, ID 83501-2431

Ph: (208) 750-7300

Reviews and Comments


Family Medicine Doctors in Lewiston, ID

Dr. Christina R Bjornstad, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 625 6th Ave, Lewiston, ID 83501
Phone: 208-743-8226    Fax: 208-746-2069
Larry Dean Harries, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 307 St Johns Way, Ste 4, Lewiston, ID 83501
Phone: 208-743-8585    Fax: 208-743-0118
Dr. Christine C Schaller, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2315 8th St, Lewiston, ID 83501
Phone: 208-983-5120    Fax: 208-983-5404
Dr. Donald J Greggain, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 415 6th St Ste 3c, Lewiston, ID 83501
Phone: 208-750-3840    Fax: 208-750-3839
Glenn E Jefferson Jr., MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2315 8th St, Lewiston, ID 83501
Phone: 208-746-1383    Fax: 208-746-6348
Cheryl A Mallory, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2315 8th St, Lewiston, ID 83501
Phone: 208-746-1383    Fax: 208-746-6348
Celso R Chavez, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1522 17th St, Lewiston, ID 83501
Phone: 208-743-8416    Fax: 208-743-4642

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.