THOMAS RUDISILL
NPI 1174283584
Nurse Practitioner - Family in Salem, OR

Q: What is Thomas Rudisill's NPI number?

The NPI number for Thomas Rudisill is 1174283584. It was assigned to this individual provider in the NPPES registry on December 27, 2021.

Q: What is Thomas Rudisill's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Rudisill was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 December 27, 2021PECOS EnrolledAccepts Medicare Assignment

5050 SKYLINE VILLAGE LOOP S, SALEM, OR 97306(503) 391-1110 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Thomas Rudisill NPPES

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

THOMAS RUDISILL (NPI 1174283584) is an individual family provider in Salem, Oregon, licensed in Oregon (202114701NP-PP) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, is affiliated with Salem Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1174283584

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameTHOMAS RUDISILL

Location Address5050 SKYLINE VILLAGE LOOP SSalem, OR 97306-9490

Mailing Address5050 Skyline Village Loop SSalem, OR 97306-9490 · (503) 391-1110

Phone(503) 391-1110

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateDecember 27, 2021

NPPES CertifiedDecember 27, 2021

✔ NPI 1174283584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OR · 202114701NP-PP

5050 SKYLINE VILLAGE LOOP S, Salem, OR 97306

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.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

Thomas Rudisill 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.

PECOS PAC ID840683298

PECOS Enrollment IDI20220207001297

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 Billing Reassignments

Medicare enrollment records show Thomas Rudisill reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Salem Health

3.9 mi

General Acute Care Hospital

890 OAK ST SE
Salem, OR 97301

Reassigned Medicare billing, Oregon enrollment
625 clinicians in this Medicare group

NPI 1265431829 (503) 561-5200

Salem Health West Valley

12 mi

Critical Access

525 SE WASHINGTON ST
Dallas, OR 97338

Reassigned Medicare billing, Oregon enrollment
254 clinicians in this Medicare group

NPI 1245237486 (503) 623-8301

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 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

149 services98 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

67 services59 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

38 services38 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

14 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Salem Hospital

Acute Care Hospitals · Salem, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number380051

Location890 Oak Street, SESalem, OR 97301 · Marion County

Emergency services Birthing friendly

West Valley Hospital

Critical Access Hospitals · Dallas, OR

OwnershipVoluntary non-profit - Private

CMS Certification Number381308

Location525 SE Washington StreetDallas, OR 97338 · Polk County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97306 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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.

Other Providers at the Same Location NPPES 20

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

JOSEPH J THALER MD

Internal Medicine