HANNAH RAE RUDOLPH – Physician Assistant, NPI 1003540204
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
Provider Addresses for HANNAH RAE RUDOLPH
1295 WATERTREE RD
TERRE HAUTE, IN 478037712
Phone: (812) 240-6763
Type: Mailing
111 NEW HAMPSHIRE AVE STE 2
PORTSMOUTH, NH 038012864
Phone:
Type: Mailing
2800 S STATE ROAD 135 STE 250
GREENWOOD, IN 461436223
Phone: (317) 300-1788
Fax: (317) 743-8103
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 48 Open Payments records for all available years, with a total value of $1,201.
Total Amount is formed as General ($1,201) + Research ($0) + Ownership ($0) = $1,201.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: SUN PHARMACEUTICAL INDUSTRIES INC. ($265).
Total Amount
$1,201
General + Research + Ownership
Payments
48
Total payment records
General Amount
$1,201
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SUN PHARMACEUTICAL INDUSTRIES INC. | $265 |
| ABBVIE INC. | $164 |
| Galderma Laboratories, L.P. | $158 |
| GENZYME CORPORATION | $143 |
| Amgen Inc. | $103 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240815003025 | I | Physician Assistant | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 47803)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | NH | |
| D E R M A T O L O G Y | NH | |
| D E R M A T O L O G Y | NH | |
| D E R M A T O L O G Y | IN | |
| Nurse Practitioner | OH | |
| D E R M A T O L O G Y | OH | |
| Physician Assistant | NH | |
| Physician Assistant | OH | |
| Physician Assistant | IN | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | NH |
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