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JACOB MICHAEL RUDOCK MD
NPI 1942130380
Student in an Organized Health Care Education/Training Program in Ann Arbor, MI

Active since May 19, 2026PECOS Enrolled
400 E EISENHOWER PKWY BLDG 2, ANN ARBOR, MI 48108(734) 539-5080 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Jacob Michael Rudock Md NPPES

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

JACOB MICHAEL RUDOCK MD (NPI 1942130380) is an individual student in an organized health care education/training program in Ann Arbor, Michigan, licensed in Michigan (4351055597) and active in the NPI registry since May 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942130380
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB MICHAEL RUDOCKCredential: MD
Location Address400 E EISENHOWER PKWY BLDG 2Ann Arbor, MI 48108-3302
Mailing Address1200 E Hospital Dr, D3230Ann Arbor, MI 48109 · (734) 647-1774
Phone(734) 539-5080
Sole ProprietorNo
Enumeration DateMay 19, 2026
NPPES CertifiedMay 13, 2026
✔ NPI 1942130380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MI · 4351055597
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
400 E EISENHOWER PKWY BLDG 2, Ann Arbor, MI 48108
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Michael Rudock 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.

Other Providers at the Same Location NPPES

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

OLEN FOSS BOWEN-GRAHAM CCC-SLP
Speech-Language Pathologist
400 E EISENHOWER PKWY BLDG 2
ANN ARBOR, MI 48108
Washtenaw County (734) 232-3270

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 Jacob Rudock's NPI number?

The NPI number for Jacob Rudock is 1942130380. It was assigned to this individual provider in the NPPES registry on May 19, 2026.

Where is Jacob Rudock located?

Jacob Rudock practices at 400 E Eisenhower Pkwy Bldg 2, Ann Arbor, MI 48108. The listed phone number is (734) 539-5080.

What is Jacob Rudock's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Rudock enrolled in Medicare?

Yes. Jacob Rudock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Rudock was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.