Nicholas Lee Rudolph, in Waseca, MN - Medicare Physical Therapist Provider

Nicholas Lee Rudolph, is a medicare enrolled "Physical Therapist" provider in Waseca, Minnesota. His current practice location is 501 State St N, Waseca, Minnesota. You can reach out to his office (for appointments etc.) via phone at (507) 781-8261.

Nicholas Lee Rudolph is licensed to practice in Minnesota (license number 11207) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104312834.

Contact Information

	Nicholas Lee Rudolph,
	501 State St N, Waseca, MN 56093-2811
	(507) 781-8261
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nicholas Lee Rudolph
Gender	Male
Speciality	Physical Therapist
Location	501 State St N, Waseca, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104312834
Provider Enumeration Date: 07/05/2018
Last Update Date: 04/19/2021

Medicare PECOS Information:

PECOS PAC ID: 0143561126
Enrollment ID: I20190702000168

Medical Identifiers

Medical identifiers for Nicholas Lee Rudolph such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104312834	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	11207 (Minnesota)	Primary

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. Nicholas Lee Rudolph allows following entities to bill medicare on his behalf.

Provider Name	Fairview Health Services
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461

Provider Name	Fairview Express Care
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548

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. Nicholas Lee 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 Address	Practice Location Address
Nicholas Lee Rudolph, 320 22nd Ave Ne, Waseca, MN 56093-2670 Ph: (507) 461-1998	Nicholas Lee Rudolph, 501 State St N, Waseca, MN 56093-2811 Ph: (507) 781-8261

Reviews and Comments

Physical Therapist in Waseca, MN

Dr. Regan Marie Kriechbaum, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 501 State St N, Waseca, MN 56093 Phone: 507-781-8265 Fax: 501-781-8110
Elizabeth Thon, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 501 State St N, Waseca, MN 56093 Phone: 507-781-8261
Ryan Craig Buchele, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 501 State St N, Waseca, MN 56093 Phone: 507-781-8259 Fax: 507-781-8110
Stephanie Strandberg, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 501 State St N, Waseca, MN 56093 Phone: 507-781-8265
Mr. Joshua Douglas Berndt, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 501 State St N, Waseca, MN 56093 Phone: 507-781-8261
Kelsey Nicole Raddawi, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 501 State St N, Waseca, MN 56093 Phone: 507-781-8261

Nicholas Lee Rudolph, - Medicare Physical Therapist in Waseca, MN