LO'RELL RUDOLPH DO
NPI 1922427160
Pediatrics in Dearborn, MI
About Lo'rell Rudolph Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LO'RELL RUDOLPH DO (NPI 1922427160) is an individual pediatrics provider in Dearborn, Michigan, licensed in Michigan (5101021994) and active in the NPI registry since April 2014. She has opted out of Medicare through February 11, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Lo'rell Rudolph Do has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 11, 2025 through February 11, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48126 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Lo'rell Rudolph's NPI number?
The NPI number for Lo'rell Rudolph is 1922427160. It was assigned to this individual provider in the NPPES registry on April 15, 2014.
Where is Lo'rell Rudolph located?
Lo'rell Rudolph practices at 5500 Auto Club Dr, Dearborn, MI 48126. The listed phone number is (313) 425-4500.
What is Lo'rell Rudolph's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Lo'rell Rudolph enrolled in Medicare?
No. Lo'rell Rudolph has opted out of Medicare through February 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
What insurance does Lo'rell Rudolph accept?
Health plans from Blue Cross and Blue Shield of Kansas, Inc., McLaren Health Plan Community and Molina Healthcare list Lo'rell 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.
When was this NPI record last updated?
The NPPES record for Lo'rell Rudolph was last updated on March 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Lo'rell Rudolph, DO · NPI 1922427160
Pediatrics physician in Dearborn, Michigan. Individual provider, active in the CMS NPPES registry since April 15, 2014.
## Identity
- **NPI:** 1922427160 (Entity type: Individual)
- **Enumerated:** April 15, 2014
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 5101021994 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 5500 AUTO CLUB DR, Dearborn, MI 48126
- **Phone:** (313) 425-4500
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 11, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** March 24, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1922427160) · Data from the CMS NPPES public registry.