DR. DONALD HENRY RUDICK MD NPI 1205885944
Specialist in St Marys, PA
About DR. DONALD HENRY RUDICK MD
Donald Rudick is a provider established in St Marys, Pennsylvania and his medical specialization is Specialist with more than 54 years of experience. He graduated from New York Medical College in 1970. The healthcare provider is registered in the NPI registry with number 1205885944 assigned on May 2006. The practitioner's primary taxonomy code is 174400000X with license number MD056864L (PA). The provider is registered as an individual and his NPI record was last updated 16 years ago.
| NPI | 1205885944 |
| Provider Name | DR. DONALD HENRY RUDICK MD |
| Location Address | 761 JOHNSONBURG RD SUITE 350 ST MARYS, PA 15857 |
| Location Phone | (814) 781-8669 |
| Mailing Address | 761 JOHNSONBURG RD SUITE 350 ST MARYS, PA 15857 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 1970 |
| Is Sole Proprietor? | N/A |
| Enumeration Date | 05-09-2006 |
| Last Update Date | 07-09-2007 |
Donald Rudick is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Donald Rudick is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Penn Highlands Dubois, Upmc Kane and Penn Highlands Elk.
The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: annual registration in the prescription drug monitoring program and care coordination agreements that promote improvements in patient tracking across settings. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 174400000X |
| Classification | Specialist |
| Type | Other Service Providers |
| License No. | MD056864L |
| License State | PA |
| Taxonomy Description | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Highmark Blue Shield
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
761 JOHNSONBURG RD
SUITE 350
ST MARYS, PA
ZIP 15857
Phone: (814) 781-8669
Fax: (814) 781-8671
Mailing Address
761 JOHNSONBURG RD
SUITE 350
ST MARYS, PA
ZIP 15857
Phone: (814) 781-8669
Fax: (814) 781-8671
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as Medicare providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in the Medicare program need to enroll in PECOS with their NPI number to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 5890834980 |
| PECOS Enrollment ID | I20091203000012 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order or refer Durable Medical Equipment (DMEPOS) | Yes |
| Eligible order r refer Home Health Agency (HHA) | Yes |
| Eligible order r refer Power Mobility Devices | Yes |
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Care coordination agreements that promote improvements in patient tracking across settings | Yes | N/A |
| Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care. | ||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 66Ultrasound measurement of bladder capacity after voiding (HCPCS:51798)
- 54Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope (HCPCS:52000)
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Donald Rudick is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| PENN HIGHLANDS DUBOIS | 100 HOSPITAL AVENUE DUBOIS, PA 15801 | (814) 371-2200 | Acute Care Hospitals | 390086 | |
| UPMC KANE | 4372 ROUTE 6 KANE, PA 16735 | (814) 837-8585 | Acute Care Hospitals | 390104 | |
| PENN HIGHLANDS ELK | 763 JOHNSONBURG ROAD SAINT MARYS, PA 15857 | (814) 788-8000 | Critical Access Hospitals | 391315 |
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1444738 | OTHER (01) | PA | HIGHMARK PROVIDER NUMBER |
| 060469 | MEDICARE ID-TYPE UNSPECIFIED (04) | PA | PROVIDER NUMBER |
| A46258 | MEDICARE UPIN (02) | PA | |
| 0019212650001 | MEDICAID (05) | PA |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 0 | 5 | 8 | 8 | 5 | 9 | 4 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 0 | 5 | 16 | 8 | 10 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 0 + 5 + 1 + 6 + 8 + 1 + 0 + 9 + 8 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1205885944 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1740274729 | JOHN MICHAEL GORLOWSKI M.D. Individual | Pediatrics (Adolescent Medicine) | 761 JOHNSONBURG RD SUITE 360 ST MARYS, PA 15857 (814) 781-8677 |
| 1205823424 | ELK REGIONAL PROFESSIONAL GROUP, INC. Organization | Surgery | 761 JOHNSONBURG RD ERPG SPECIALTY SERVICES SAINT MARYS, PA 15857 (814) 788-8615 |
| 1699722231 | JOSEPH & SUBRAMANY, INC. Organization | Specialist | 761 JOHNSONBURG RD SUITE 130 ST MARYS, PA 15857 (814) 781-1188 |
| 1578628806 | LEI CHEN MD Individual | Obstetrics & Gynecology (Obstetrics) | 761 JOHNSONBURG RD ST MARYS, PA 15857 (814) 834-6139 |
| 1053509513 | TRI-COUNTY UROLOGY INC Organization | Urology | 761 JOHNSONBURG RD SUITE 350 SAINT MARYS, PA 15857 (814) 781-8669 |
| 1043477946 | JOHN M GORLOWSKI MD PC Organization | Pediatrics (Adolescent Medicine) | 761 JOHNSONBURG RD SUITE 360 SAINT MARYS, PA 15857 (814) 781-8677 |
| 1447231378 | DR. TED BRUBAKER ESHBACH M.D. Individual | Orthopaedic Surgery | 761 JOHNSONBURG RD SUITE 310 ST MARYS, PA 15857 (814) 834-1686 |
| 1609889583 | DAVID HOWARD JOHE MD Individual | Orthopaedic Surgery | 761 JOHNSONBURG RD SAINT MARYS, PA 15857 (814) 781-8655 |
| 1336120146 | MS. MEGEN HANDLEY CRNP Individual | Nurse Practitioner | 761 JOHNSONBURG RD SUITE 310 ST MARYS, PA 15857 (814) 834-1686 |
| 1407858277 | ANNE M BREINDEL PA-C Individual | Physician Assistant (Medical) | 761 JOHNSONBURG RD SUITE 240 SAINT MARYS, PA 15857 (814) 834-6565 |
| 1861401424 | DR. STEVEN KOCH MD Individual | Obstetrics & Gynecology | 761 JOHNSONBURG RD SUITE 210 SAINT MARYS, PA 15857 (814) 788-8118 |
| 1124403035 | DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS FAMILY MEDICINE Organization | Family Medicine | 761 JOHNSONBURG RD SUITE 240 SAINT MARYS, PA 15857 (814) 788-8183 |
| 1043687213 | DUBOIS REGIONAL MED CENTER - PENN HIGHLANDS FAMILY MED ST MARYS 94150 Organization | Family Medicine | 761 JOHNSONBURG RD SUITE 220 SAINT MARYS, PA 15857 (814) 834-2850 |
| 1831574375 | DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS MEDICAL ARTS BLDG ELK Organization | Family Medicine | 761 JOHNSONBURG RD SAINT MARYS, PA 15857 (814) 371-2200 |
| 1952715914 | MRS. FRANCESCA WOELFEL PA-C Individual | Physician Assistant (Medical) | 761 JOHNSONBURG RD SUITE 240 SAINT MARYS, PA 15857 (814) 834-6565 |
| 1205849197 | MRS. ANDREA LEE INZANA PA-C Individual | Physician Assistant | 761 JOHNSONBURG RD SUITE 310 SAINT MARYS, PA 15857 (814) 834-1686 |
| 1700239068 | SARAH MEANS PA-C Individual | Physician Assistant | 761 JOHNSONBURG RD SUITE 210 SAINT MARYS, PA 15857 (814) 788-8118 |
| 1881870905 | DR. ANUJIT SINGH DO Individual | Internal Medicine | 761 JOHNSONBURG RD SUITE 220 SAINT MARYS, PA 15857 (814) 788-8184 |
| 1437693868 | MRS. NICOLE LYNN VILLELLA CRNP Individual | Nurse Practitioner | 761 JOHNSONBURG RD SAINT MARYS, PA 15857 (814) 788-8777 |
| 1922648724 | ERIN MARY MCMAHON CRNP Individual | Nurse Practitioner (Women's Health) | 761 JOHNSONBURG RD SAINT MARYS, PA 15857 (814) 788-8118 |
Frequently Asked Questions
What is Dr. Donald Rudick MD NPI number?
The NPI number assigned to this healthcare provider is 1205885944, enumerated in the NPI registry as an "individual" on May 09, 2006
Where is the provider located?
The provider is located at 761 Johnsonburg Rd Suite 350 St Marys, Pa 15857 and the phone number is (814) 781-8669
What is the provider specialty code?
The provider's speciality is Specialist with taxonomy code 174400000X
How many years of experience does Dr. Donald Rudick MD have?
The provider has more than 54 years of experience. He graduated from New York Medical College in 1970.
What insurance does Dr. Donald Rudick MD accept?
The provider might be accepting Highmark Blue Shield, Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Donald Rudick MD registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What are some of the services provided by Dr. Donald Rudick MD?
The most common procedures or services performed by this practitioner are: Ultrasound measurement of bladder capacity after voiding and Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope.
Is Dr. Donald Rudick MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: PENN HIGHLANDS DUBOIS, UPMC KANE and PENN HIGHLANDS ELK. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
This NPI record was last updated on May 09, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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