GLEN H RUDOLPH M.D.
NPI 1124258223
Orthopaedic Surgery in Duluth, MN
About Glen H Rudolph M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GLEN H RUDOLPH M.D. (NPI 1124258223) is an individual orthopaedic surgery provider in Duluth, Minnesota, licensed in Minnesota (50713) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with University Medical Center-mesabi/ Mesaba Clinics, and is a graduate of University Of Minnesota Medical School (2006).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Glen H Rudolph M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Glen Rudolph reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Duluth, MN 55805
- Reassigned Medicare billing, Minnesota and Wisconsin enrollments
- Medicare enrollment name: Orthopedic Associates Of Duluth PA
- 27 clinicians in this Medicare group
Hibbing, MN 55746
- Reassigned Medicare billing, Minnesota enrollment
- 707 clinicians in this Medicare group
Grand Rapids, MN 55744
- Reassigned Medicare billing, Minnesota enrollment
- 555 clinicians in this Medicare group
International Falls, MN 56649
- Reassigned Medicare billing, Minnesota enrollment
- 39 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 11
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Medical Center-Mesabi/ Mesaba Clinics
Acute Care Hospitals · Hibbing, MNSt Lukes Hospital
Acute Care Hospitals · Duluth, MNGrand Itasca Clinic And Hospital
Acute Care Hospitals · Grand Rapids, MNRainy Lake Medical Center
Critical Access Hospitals · International Falls, MNCommunity Memorial Hospital
Critical Access Hospitals · Cloquet, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
DULUTH, MN 55805
DULUTH, MN 55805
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 Glen Rudolph's NPI number?
The NPI number for Glen Rudolph is 1124258223. It was assigned to this individual provider in the NPPES registry on July 23, 2009.
Where is Glen Rudolph located?
Glen Rudolph practices at 1000 E 1st St Ste 404, Duluth, MN 55805. The listed phone number is (218) 722-5513.
What is Glen Rudolph's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.
Is Glen Rudolph enrolled in Medicare?
Yes. Glen Rudolph is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Glen Rudolph's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Glen Rudolph reassigns Medicare benefits to 4 organizations: Orthopedic Associates Of Duluth, P.A. (Duluth, MN), Range Regional Health Services (Hibbing, MN), Grand Itasca Clinic And Hospital (Grand Rapids, MN) and International Falls Memorial Hospital Association (International Falls, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Glen Rudolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Glen Rudolph accept?
Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross Blue Shield of North Dakota, HealthPartners and Sanford Health Plan and 1 other insurer list Glen Rudolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Glen Rudolph affiliated with any hospitals?
According to CMS data, Glen Rudolph is affiliated with University Medical Center-Mesabi/ Mesaba Clinics, St Lukes Hospital, Grand Itasca Clinic And Hospital, Rainy Lake Medical Center and Community Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Glen Rudolph was last updated on March 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Glen H Rudolph, M.D. · NPI 1124258223
Orthopaedic Surgery physician in Duluth, Minnesota. Individual provider, active in the CMS NPPES registry since July 23, 2009.
## Identity
- **NPI:** 1124258223 (Entity type: Individual)
- **Enumerated:** July 23, 2009
- **Primary specialty:** Orthopaedic Surgery · taxonomy 207X00000X
- **State license:** 50713 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 E 1ST ST STE 404, Duluth, MN 55805-2297
- **Phone:** (218) 722-5513 · **Fax:** (218) 722-6515
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Orthopedic Associates Of Duluth, P.A. (NPI 1225033715, Duluth, MN); Range Regional Health Services (NPI 1356321699, Hibbing, MN); Grand Itasca Clinic And Hospital (NPI 1669426631, Grand Rapids, MN); International Falls Memorial Hospital Association (NPI 1528041183, International Falls, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 2006
## Record status
- **NPPES last updated:** March 12, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1124258223) · Data from the CMS NPPES public registry.