SUSAN EVELYN RUDOLPH (M.D.) – Dermatology Physician, NPI 1043244213
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
419 DERMATOLOGY in MN
Provider Addresses for SUSAN EVELYN RUDOLPH (M.D.)
3916 W 50th St
Edina, MN 554241202
Phone: (612) 920-7546
Fax: (612) 920-7548
Type: Location
Chicago Av, Washington Avenue South, Minneapolis, Hennepin County, Minnesota, 55415:55454, United States
MINNEAPOLIS, MN 554071321
Phone: (612) 262-5000
Type: Mailing
1217, 8th North Street, New Ulm, Brown County, Minnesota, 56073, United States
NEW ULM, MN 56073
Phone: (507) 217-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $60.
Total Amount is formed as General ($60) + Research ($0) + Ownership ($0) = $60.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Incyte Corporation ($60).
Total Amount
$60
General + Research + Ownership
Payments
1
Total payment records
General Amount
$60
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Incyte Corporation | $60 |
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: 2008-08-27
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 |
|---|---|---|---|---|
| I20080827000180 | I | Dermatology | MN | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,035 | 157 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 397 | 298 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 276 | 220 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 175 | 175 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 174 | 150 | $0 |
Insurance plans in this area (ZIP 55424)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease | CO | |
| Qualified Audiologist | MN | |
| Family Practice | MN | |
| - | MN | |
| Family Practice | MN | |
| Nurse Practitioner | ND | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
Reviews
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