TERESA L RUDOLPH MD
NPI 1104869379
Family Medicine in Neenah, WI

Q: What is Teresa Rudolph's NPI number?

The NPI number for Teresa Rudolph is 1104869379. It was assigned to this individual provider in the NPPES registry on June 14, 2006. The provider is also known as Teresa L Shoberg.

Q: What is Teresa Rudolph's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Teresa Rudolph was last updated on April 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since June 14, 2006PECOS Enrolled

1504 S COMMERCIAL ST, NEENAH, WI 54956(920) 729-6088(920) 729-6484 Get Directions Write a Review

NPPES record last updated: April 14, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Teresa L Rudolph Md NPPES

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

TERESA L RUDOLPH MD (NPI 1104869379) is an individual family medicine provider in Neenah, Wisconsin, licensed in Wisconsin (31387) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104869379

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameTERESA L RUDOLPHCredential: MD

Location Address1504 S COMMERCIAL STNeenah, WI 54956-4802

Mailing AddressPo Box 8003Appleton, WI 54912-8003 · (920) 996-3200 · Fax (920) 738-5787

Phone(920) 729-6088

Fax(920) 729-6484

Sole ProprietorNo

Enumeration DateJune 14, 2006

Last NPPES UpdateApril 14, 2011

✔ NPI 1104869379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 31387

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1504 S COMMERCIAL ST, Neenah, WI 54956

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Other Names 1

Former Name (1)Teresa L Shoberg

Other Identifiers 2

Medicaid31670900WI

Medicare UPINF31139

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Teresa L Rudolph Md 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54956 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers18 claims63 services$5.34 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier21 claims21 services$17.58 avg. paid by Medicare

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 supplier21 claims21 services$90.90 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$185.34 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.

KRYSTINA MARIE PISCHKE

Family Medicine