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RANDAL RUDDERMAN MD
NPI 1639263676
Surgery - Plastic and Reconstructive Surgery in Alpharetta, GA

Active since October 03, 2006PECOS Enrolled
3400-C OLD MILTON PKWY,, STE 450, ALPHARETTA, GA 30005(678) 566-7200(678) 566-7210 Get Directions Write a Review

NPPES record last updated: June 22, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Randal Rudderman Md NPPES

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

RANDAL RUDDERMAN MD (NPI 1639263676) is an individual plastic and reconstructive surgery provider in Alpharetta, Georgia, licensed in Georgia (024863) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639263676
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameRANDAL RUDDERMANCredential: MD
Location Address3400-C OLD MILTON PKWY,, STE 450Alpharetta, GA 30005-3707
Mailing Address3400-c Old Milton Pkwy,, Ste 450Alpharetta, GA 30005-3707 · (678) 566-7200 · Fax (678) 566-7210
Phone(678) 566-7200
Fax(678) 566-7210
Sole ProprietorYes
Enumeration DateOctober 3, 2006
Last NPPES UpdateJune 22, 2015
✔ NPI 1639263676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in GA · 024863
Definition
A surgeon who specializes in plastic and reconstructive surgery.
Also ListedSpecialistTaxonomy 174400000X · License 024863 (GA)
3400-C OLD MILTON PKWY,, Alpharetta, GA 30005
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Other Identifiers 1

Medicare UPIND30667

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randal Rudderman 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.

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 Randal Rudderman's NPI number?

The NPI number for Randal Rudderman is 1639263676. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Randal Rudderman located?

Randal Rudderman practices at 3400-C Old Milton Pkwy, Ste 450, Alpharetta, GA 30005. The listed phone number is (678) 566-7200.

What is Randal Rudderman's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Randal Rudderman enrolled in Medicare?

Yes. Randal Rudderman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Randal Rudderman was last updated on June 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.