NICHOLAS LEE RUDOLPH – Physical Therapist, NPI 1104312834

Physical Therapist

NICHOLAS LEE RUDOLPH is a healthcare provider. based in Hugo, Minnesota. specializing in Physical Therapist. They hold a License No. 11207 (MN). The NPI Number for NICHOLAS LEE RUDOLPH is 1104312834

Main info

Male

8 Years Of Experience

Accepts Medicare Assignment

Name

NICHOLAS LEE RUDOLPH

NPI

1104312834

Phone

(651) 466-1950

Address

14712 VICTOR HUGO BLVD N

Enumeration Date

5 July 2018

Last Update Date

19 April 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6514661900

Graduation Year

2018 (8 years ago)

PAC ID

0143561126

Group Practice PAC ID

1951213057

Professional Enrollment ID

I20190702000168

Contacts

Secure Messaging

nrudolph1375801@ehrdirect.mayoclinicmsg.org

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience38

Completeness85

Years active:7State licenses:1Other namesUpdated within 12 months

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Provider Addresses for NICHOLAS LEE RUDOLPH

Victor Hugo Blvd N, Hugo, Washington County, Minnesota, 55038, United States
HUGO, MN 550386419
Phone: (651) 466-1950
Type: Location
501 STATE ST N
WASECA, MN 560932811
Phone: (507) 781-8261
Type: Location
6515 Barrie Rd Ste 100
Edina, MN 554352364
Phone: (952) 922-5019
Type: Location
14712 Victor Hugo Blvd N
Hugo, MN 550386419
Phone: (651) 466-1950
Type: Location
320, 22nd Avenue Northeast, Waseca, Waseca County, Minnesota, 56093, United States
WASECA, MN 560932670
Phone: (507) 461-1998
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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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 55038)

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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: 1951213057View full group profile

Name	Specialty	State
DR. JOHN PAUL BERGER (D.O.)	Pulmonary Disease	CO
DON COLEMAN	-	MN
SARAH NICOLE OLSON VENNING (LICSW)	-	MN
CHARITO M SANTOS (MD)	Family Practice	MN
BREANNA PETERSON (D.O.)	-	MO
LYDIA NYAKONU SHERMAN (CNP)	-	MN
KELLY JEAN KILLIAN (NP)	-	VA
MR. JENS PREM TAMANG (OTR)	-	MN
MS. RENEE HAROLDSON (OTRL CHT)	-	MN
DR. JULIE LIN BECKER (MD)	O B S T E T R I C S/ G Y N E C O L O G Y	MN