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CARLA RUDOLPH DO
NPI 1104182328
General Practice in Edgewood, NM

Active since April 02, 2012PECOS Enrolled
80.33/100
CMS Quality Rating
1851 OLD US 66, EDGEWOOD, NM 87015(505) 286-2396 Get Directions Write a Review

NPPES record last updated: May 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 4, 2020, Jun 15, 2018 (2 updates tracked since 2018).

About Carla Rudolph Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLA RUDOLPH DO (NPI 1104182328) is an individual general practice provider in Edgewood, New Mexico, licensed in New Mexico (A-1770-13) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104182328
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameCARLA RUDOLPHCredential: DO
Location Address1851 OLD US 66Edgewood, NM 87015-7200
Mailing Address1851 Old Us 66Edgewood, NM 87015-7200 · (505) 286-2396
Phone(505) 286-2396
Sole ProprietorNo
Enumeration DateApril 2, 2012
Last NPPES UpdateMay 4, 20202 updates tracked since enumeration
NPPES CertifiedMay 4, 2020
✔ NPI 1104182328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in NM · A-1770-13
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1851 OLD US 66, Edgewood, NM 87015
Open in Google Maps ↗

Other Identifiers 1

Medicaid1104182328NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carla Rudolph Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality61.79
Promoting Interoperability100
Improvement Activities40
Cost72.64

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier24 claims24 services$77.73 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier20 claims20 services$34.47 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALYSSA BRIANA MIRABAL MD
Family Medicine
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 286-2396
HARRY SCHNEE MESSEC MD
Family Medicine
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 286-2396
SANDIA MOUNTAIN MEDICAL, INC.
Family Medicine
1851 OLD US 66, UNIT 1
EDGEWOOD, NM 87015
Santa Fe County (505) 286-2396
DR. SANFORD LEE YANKOW MD
Family Medicine
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 286-2396
MRS. KRISTAL LEANN WALLACE FNP-BC
Nurse Practitioner (Family)
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 286-2396
BEBE MAKENA OTR/L
Occupational Therapist
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 281-8463
DR. LARISA MAUREEN HART VASQUEZ DPT
Physical Therapist
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 281-8463
JOSHUA JONES PA-C
Physician Assistant
1851 OLD US 66
EDGEWOOD, NM 87015
Santa Fe County (505) 286-2396

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carla Rudolph's NPI number?

The NPI number for Carla Rudolph is 1104182328. It was assigned to this individual provider in the NPPES registry on April 2, 2012.

Where is Carla Rudolph located?

Carla Rudolph practices at 1851 Old Us 66, Edgewood, NM 87015. The listed phone number is (505) 286-2396.

What is Carla Rudolph's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Carla Rudolph enrolled in Medicare?

Yes. Carla Rudolph is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carla Rudolph was last updated on May 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.