DR. ADAM R RUDOLPH (MD) – Family Medicine Physician, NPI 1821593369
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
886 FAMILY PRACTICE in ME
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Provider Addresses for DR. ADAM R RUDOLPH (MD)
75, Frances Street, Rosemont, Portland, Cumberland County, Maine, 04102, United States
PORTLAND, ME 041022511
Phone: (812) 789-3887
Type: Mailing
Maine Medical Center, 22, Bramhall Street, West End, Portland, Cumberland County, Maine, 04102, United States
PORTLAND, ME 041023175
Phone: (207) 662-0111
Type: Location
PO BOX 1510
EVANSVILLE, IN 477061510
Phone: (812) 450-6815
Fax: (812) 450-6822
Type: Mailing
1004 E ILLINOIS ST
PETERSBURG, IN 475678068
Phone: (812) 354-1052
Fax: (812) 354-8280
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2021-08-13
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 |
|---|---|---|---|---|
| I20210813002949 | I | Family Practice | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 81003 | Automated urinalysis test | 12 | 11 | $0 |
Insurance plans in this area (ZIP 04102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| Family Practice | MI | |
| Family Practice | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| - | TN | |
| Nurse Practitioner | IN | |
| - | KY | |
| Physician Assistant | OH | |
| Internal Medicine, Geriatric Medicine | IN |
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