DR. JOHN BRADLEY RUDOLPH D.O.
NPI 1548503022
Family Medicine in Lewiston, ID

Q: What is John Rudolph's NPI number?

The NPI number for John Rudolph is 1548503022. It was assigned to this individual provider in the NPPES registry on April 3, 2013.

Q: What is John 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 John Rudolph was last updated on December 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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 April 03, 2013PECOS EnrolledAccepts Medicare Assignment

415 6TH ST STE 3C, LEWISTON, ID 83501(208) 750-7300(208) 746-4899 Get Directions Write a Review

NPPES record last updated: December 26, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 26, 2024, Jun 18, 2024, Aug 18, 2021 and 1 more (4 updates tracked since 2017).

On this page

About Dr. John Bradley Rudolph D.o. NPPES

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

DR. JOHN BRADLEY RUDOLPH D.O. (NPI 1548503022) is an individual family medicine provider in Lewiston, Idaho, licensed in Idaho (O-0990) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with St Joseph Regional Medical Center, and maintains a secondary practice location in Clarkston.

NPPES Registry Identity

NPI1548503022

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JOHN BRADLEY RUDOLPHCredential: D.O.

Location Address415 6TH ST STE 3CLewiston, ID 83501-2431

Mailing Address415 6th Street, Attn: Physician ServicesLewiston, ID 83501-2434 · (208) 750-7462 · Fax (208) 750-7467

Phone(208) 750-7300

Fax(208) 746-4899

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateApril 3, 2013

Last NPPES UpdateDecember 26, 20244 updates tracked since enumeration

NPPES CertifiedDecember 26, 2024

✔ NPI 1548503022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in ID · O-0990✔ Licensed in WA · OP60506022

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.

415 6TH ST STE 3C, Lewiston, ID 83501

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Secondary Practice Location 1

Location 11119 Highland AveClarkston, WA 99403-2836 · Phone (509) 758-1450 · Fax (509) 751-1504

Accepted Insurance

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

Dr. John Bradley Rudolph D.o. 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 ID1759604309

PECOS Enrollment IDI20150106001908, I20170116000186

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 John Rudolph reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St Joseph Hospital LLC

Same address

Internal Medicine

415 6TH STREET, PHYSICIAN SERVICES
Lewiston, ID 83501

Reassigned Medicare billing, Idaho and Washington enrollments
Also billed through NPI 1043744287 (Washington)
164 clinicians in this Medicare group

NPI 1205368404 (208) 750-7462

Tri-State Memorial Hospital

1.1 mi

End-Stage Renal Disease (ESRD) Treatment

730 21ST ST
Lewiston, ID 83501

Reassigned Medicare billing, Idaho enrollment
25 clinicians in this Medicare group

NPI 1386690907 (208) 746-8280

Vannvei LLC

1.1 mi

Multi-Specialty

1522 17TH ST
Lewiston, ID 83501

Reassigned Medicare billing, Idaho enrollment
32 clinicians in this Medicare group

NPI 1881200517 (208) 743-8416

Meza Post Acute And Long Term Care, PLLC

89 mi

Geriatric Medicine

2426 N MERRITT CREEK LOOP STE A
Coeur D Alene, ID 83814

Reassigned Medicare billing, Idaho and Washington enrollments
30 clinicians in this Medicare group

NPI 1932725215 (208) 819-2183

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 19

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

1,027 services329 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

470 services261 patients

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.

253 services140 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

83 services82 patients

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

71 services65 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.

69 services69 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

58 services56 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.

45 services37 patients

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

37 services37 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

35 services35 patients

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

29 services28 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

28 services18 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

26 services22 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

25 services24 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

23 services23 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

21 services21 patients

Nursing facility discharge day management, 30 minutes or less 99315

18 services18 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

18 services18 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

16 services12 patients

Hospital Affiliations CMS Care Compare 4

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

St Joseph Regional Medical Center

Acute Care Hospitals · Lewiston, ID

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130003

Location415 Sixth StreetLewiston, ID 83501 · Nez Perce County

Emergency services Birthing friendly

Syringa General Hospital

Critical Access Hospitals · Grangeville, ID

OwnershipGovernment - Hospital District or Authority

CMS Certification Number131315

Location607 W Main StreetGrangeville, ID 83530 · Idaho County

Emergency services

St Marys Hospital And Clinics

Critical Access Hospitals · Cottonwood, ID

OwnershipVoluntary non-profit - Private

CMS Certification Number131321

Location701 Lewiston StCottonwood, ID 83522 · Idaho County

Emergency services

Tri-State Memorial Hospital

Critical Access Hospitals · Clarkston, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number501332

Location1221 Highland AvenueClarkston, WA 99403 · Asotin County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83501 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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 18

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

7 suppliers60 claims162 services$6.07 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each A4373

DME-Orthotic Devices · category DF010N

1 supplier11 claims220 services$5.26 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425

DME-Orthotic Devices · category DF010N

1 supplier11 claims148 services$3.35 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

4 suppliers19 claims19 services$37.50 avg. paid by Medicare

Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6203

DME-Medical/Surgical Supplies · category DA023N

2 suppliers14 claims174 services$3.17 avg. paid by Medicare

Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212

DME-Medical/Surgical Supplies · category DA023N

3 suppliers12 claims135 services$9.39 avg. paid by Medicare

Hydrogel dressing, wound filler, gel, per fluid ounce A6248

DME-Medical/Surgical Supplies · category DA023N

3 suppliers11 claims23 services$15.70 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

3 suppliers18 claims73 services$19.35 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

3 suppliers16 claims16 services$57.65 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

4 suppliers16 claims16 services$18.63 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers22 claims104 services$2.43 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

4 suppliers12 claims12 services$11.85 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 supplier24 claims24 services$18.12 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

2 suppliers54 claims54 services$88.07 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier15 claims15 services$32.28 avg. paid by Medicare

Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches E2201

DME-Wheelchairs · category DD021N

1 supplier11 claims11 services$26.34 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

3 suppliers45 claims45 services$22.19 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

7 suppliers56 claims56 services$183.91 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 5

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

DR. DONALD J GREGGAIN M.D.

Family Medicine

415 6TH ST STE 3C
LEWISTON, ID 83501

Nez Perce County (208) 750-3840

JENNA DARNELL

Nurse Practitioner (Family)

415 6TH ST STE 3C
LEWISTON, ID 83501

Nez Perce County (208) 750-3840

BELINDA ROBERTS NP

Nurse Practitioner (Family)

415 6TH ST STE 3C
LEWISTON, ID 83501

Nez Perce County (208) 746-1333

DR. BARBARA KAY DAVIS MD

Internal Medicine

415 6TH ST STE 3C
LEWISTON, ID 83501

Nez Perce County (208) 746-1333

KAYLA MILLER

Nurse Practitioner (Family)

415 6TH ST STE 3C
LEWISTON, ID 83501

Nez Perce County (208) 750-7300

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 John Rudolph's NPI number?

The NPI number for John Rudolph is 1548503022. It was assigned to this individual provider in the NPPES registry on April 3, 2013.

Where is John Rudolph located?

John Rudolph practices at 415 6th St Ste 3C, Lewiston, ID 83501. The listed phone number is (208) 750-7300.

What is John Rudolph's specialty?

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

Is John Rudolph enrolled in Medicare?

Yes. John 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 John Rudolph's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Rudolph reassigns Medicare benefits to 4 organizations: St Joseph Hospital LLC (Lewiston, ID), Tri-State Memorial Hospital (Lewiston, ID), Vannvei LLC (Lewiston, ID) and Meza Post Acute And Long Term Care, PLLC (Coeur D Alene, ID). 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 John Rudolph's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Rudolph accept?

Health plans from Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan and 1 other insurer list John 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 John Rudolph affiliated with any hospitals?

According to CMS data, John Rudolph is affiliated with St Joseph Regional Medical Center, Syringa General Hospital, St Marys Hospital And Clinics and Tri-State Memorial Hospital.

When was this NPI record last updated?

The NPPES record for John Rudolph was last updated on December 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.