DR. JORDAN SAMUEL RUDMAN (MD) – Emergency Medicine Physician, NPI 1154901452

DR. JORDAN SAMUEL RUDMAN (MD) is a healthcare provider. based in Boston, Massachusetts. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 234033 (AK). The NPI Number for DR. JORDAN SAMUEL RUDMAN (MD) is 1154901452

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. JORDAN SAMUEL RUDMAN (MD)
NPI
1154901452
Phone
Not provided
Address
1 DEACONESS RD
Enumeration Date
11 April 2021
Last Update Date
11 July 2025

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
4252283440
Graduation Year
2022 (4 years ago)
PAC ID
3173047289
Group Practice PAC ID
7911892054
Professional Enrollment ID
I20250717002665
Address ID
WA980555714RE400XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:5State licenses:2Digital endpointsOther names

1,682 EMERGENCY MEDICINE in MA

Provider Addresses for DR. JORDAN SAMUEL RUDMAN (MD)

  • 1 DEACONESS RD

    BOSTON, MA 022155321

    Phone:

    Type: Mailing

  • 325 9TH AVE # 3EC22

    SEATTLE, WA 981042499

    Phone:

    Type: Mailing

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: 2025-07-17

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250717002665IEmergency MedicineWATBD

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.

Verify on CMS Revalidation Lookup Tool

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 02215)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911892054View full group profile
NameSpecialtyState
Emergency MedicineWA
Emergency MedicineOH
Emergency MedicineCA
Emergency MedicineIL
Emergency MedicineIN
Emergency MedicineWA
Emergency MedicineWA
Emergency MedicineWA
Emergency MedicineWA
Emergency MedicineWA

Reviews

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Frequently asked questions

How do payers reference DR. JORDAN SAMUEL RUDMAN (MD)?
For DR. JORDAN SAMUEL RUDMAN (MD), use NPI 1154901452 as the unique 10-digit identifier.
Would DR. JORDAN SAMUEL RUDMAN (MD) appear as active to a payer?
You can treat DR. JORDAN SAMUEL RUDMAN (MD) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for DR. JORDAN SAMUEL RUDMAN (MD)?
At a glance, DR. JORDAN SAMUEL RUDMAN (MD) is tied to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Massachusetts is DR. JORDAN SAMUEL RUDMAN (MD) registered?
Use Boston, Massachusetts as the headline location for DR. JORDAN SAMUEL RUDMAN (MD) here.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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