DR. STEPHEN ALAN RUDOLPH M.D.; PH.D. NPI 1790728988

Internal Medicine in South Euclid, OH

Individual Male Years of Experience 35 Internal Medicine PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 94.7

About DR. STEPHEN ALAN RUDOLPH M.D.; PH.D.

Stephen Rudolph is an internist established in South Euclid, Ohio and his medical specialization is Internal Medicine with more than 35 years of experience. He graduated from Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University in 1988. The NPI number of Stephen Rudolph is 1790728988 and was assigned on June 2006. The practitioner's primary taxonomy code is 207R00000X with license number 35057968 (OH). The provider is registered as an individual and his NPI record was last updated 2 years ago.

An internist like Dr. Stephen Alan Rudolph M.d.; Ph.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

NPI

1790728988

Provider NameDR. STEPHEN ALAN RUDOLPH M.D.; PH.D.
Provider Location Address1611 S GREEN RD SUITE 260 SOUTH EUCLID, OH 44121
Provider Mailing Address1611 S GREEN RD SUITE 260 SOUTH EUCLID, OH 44121
GenderMale
NPI Entity TypeIndividual
Medical School NameCLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduation Year1988
Is Sole Proprietor?No
Enumeration Date06-14-2006
Last Update Date01-14-2021



Stephen Rudolph 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.

Stephen Rudolph 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 University Hospitals Ahuja Medical Center and University Hospitals Of Cleveland.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.7, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.89 for a new patient copayment and $25.3 for an established patient copayment.



Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.35057968
License StateOH
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

DR. STEPHEN ALAN RUDOLPH M.D.; PH.D.
1611 S GREEN RD
SUITE 260
SOUTH EUCLID, OH
ZIP 44121
Phone: (216) 381-1367
Fax: (216) 291-9740

Get Directions


Mailing Address

DR. STEPHEN ALAN RUDOLPH M.D.; PH.D.
1611 S GREEN RD
SUITE 260
SOUTH EUCLID, OH
ZIP 44121
Phone: (216) 381-1367
Fax: (216) 291-9740


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID4183616220
PECOS Enrollment IDI20061214000109
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 ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 44121 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$56.74 $173.94 $131.59
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.18 $43.48 $32.89
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.31 $141.66 $101.2
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.32 $35.41 $25.3

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 72.2
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 94.7
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

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.

  • 331Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 146Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • 130Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
  • 89Administration of pneumococcal vaccine (HCPCS:G0009)
  • 87Pneumococcal vaccine for injection into muscle (HCPCS:90670)
  • 61Administration of influenza virus vaccine (HCPCS:G0008)
  • 48Hemoglobin A1C level (HCPCS:83036)
  • 14Urinalysis, manual test (HCPCS:81002)

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. Stephen Rudolph is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
UNIVERSITY HOSPITALS AHUJA MEDICAL CENTER3999 RICHMOND ROAD
BEACHWOOD, OH 44122
(216) 593-5510Acute Care Hospitals360359
UNIVERSITY HOSPITALS OF CLEVELAND11100 EUCLID AVENUE
CLEVELAND, OH 44106
(216) 844-1000Acute Care Hospitals360137

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.
1790728988
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2718014216916
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 4 + 2 + 1 + 6 + 9 + 1 + 6 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 88

The NPI number 1790728988 is valid because the calculated check digit 8 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
1568464964DR. ROBERT T STROUP JR. MD
Individual
Plastic Surgery1611 S GREEN RD 238
SOUTH EUCLID, OH 44121
(216) 691-4000
1497748495 JONATHAN A EISENGART M.D.
Individual
Ophthalmology1611 S GREEN RD SUITE 306B
SOUTH EUCLID, OH 44121
(216) 291-3550
1457347890 JEFFREY PAUL RENSTON MD
Individual
Internal Medicine (Pulmonary Disease)1611 S GREEN RD
SOUTH EUCLID, OH 44121
(216) 297-3168
1699763714DR. DONALD C MANN MD
Individual
Psychiatry & Neurology (Neurology)1611 S GREEN RD SUITE 300
CLEVELAND, OH 44121
(216) 381-2673
1497744882 KATHLEEN A LAMPING MD
Individual
Ophthalmology1611 S GREEN RD SUITE 306A
SOUTH EUCLID, OH 44121
(216) 291-9770
1871572289DR. DAVID M. BURKONS M.D.
Individual
Obstetrics & Gynecology1611 S GREEN RD #204
SOUTH EUCLID, OH 44121
(216) 381-3880
1326019233UNIVERSITY SUBURBAN DENTAL GROUP, INC
Organization
Dentist (General Practice)1611 S GREEN RD SUITE 157
CLEVELAND, OH 44121
(216) 381-6521
1932177359DR. FREDERIC W LAFFERTY MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)1611 S GREEN RD #147
SOUTH EUCLID, OH 44121
(216) 381-1142
1659336279 ROBERT BENNETT EPPES M.D.
Individual
Dermatology1611 S GREEN RD SUITE 158
SOUTH EUCLID, OH 44121
(216) 382-9303
1679531628 MARK ROGER LEVINE M.D.
Individual
Ophthalmology1611 S GREEN RD SUITE 306A
SOUTH EUCLID, OH 44121
(219) 291-9770
1689626145 WILLIAM L ANNABLE M.D.
Individual
Ophthalmology1611 S GREEN RD SUITE 306C
CLEVELAND, OH 44121
(216) 382-8022
1598718322 RONALD L PRICE M.D.
Individual
Ophthalmology1611 S GREEN RD SUITE 306C
CLEVELAND, OH 44121
(216) 382-8022
1770538621UNIVERSITY OPHTHALMOLOGY ASSOCIATES, INC
Organization
Ophthalmology1611 S GREEN RD SUITE 306C
CLEVELAND, OH 44121
(216) 382-8022
1164461513DR. WILLIAM WAYNE STEINER M.D.; PH.D.
Individual
Internal Medicine1611 S GREEN RD SUITE 260
SOUTH EUCLID, OH 44121
(216) 382-2036
1881632362DR. HADLEY SCOTT MORGENSTERN-CLARREN M.D.
Individual
Internal Medicine1611 S GREEN RD SUITE 260
SOUTH EUCLID, OH 44121
(216) 381-4103
1700828738DR. PHILIP A. ANDERSON M.D.
Individual
Internal Medicine1611 S GREEN RD SUITE 260
SOUTH EUCLID, OH 44121
(216) 291-1650
1710918727DR. MICHAEL E SKERL DDS
Individual
Dentist (General Practice)1611 S GREEN RD SUITE 157
SOUTH EUCLID, OH 44121
(216) 381-6521
1518982735DR. RACHEL MIRIAN GARBER MD
Individual
Pediatrics1611 S GREEN RD SUITE 034
SOUTH EUCLID, OH 44121
(216) 297-2700
1093737314 MAUREEN PARNIN SIZEMORE ATC
Individual
Specialist/Technologist (Athletic Trainer)1611 S GREEN RD 036
SOUTH EUCLID, OH 44121
(216) 291-2277
1770506917 JULIE H SWARTZ ATC
Individual
Specialist/Technologist (Athletic Trainer)1611 S GREEN RD
SOUTH EUCLID, OH 44121
(216) 291-0108

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Dr. Stephen Alan Rudolph M.d.; Ph.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.