CARLA RUDOLPH (DO) – General Practice Physician, NPI 1104182328
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CARLA RUDOLPH (DO)
1851 OLD US 66
EDGEWOOD, NM 870157200
Phone: (505) 286-2396
Mailing address matches the actual address.
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 $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2023-03-16 • Largest payer in this snapshot: ABBVIE INC. ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $17 |
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: 2024-09-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20180725002373 | I | General Practice | NC | TBD |
| I20240916001436 | I | General Practice | MD | TBD |
| I20240916001764 | I | General Practice | DC | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 63 | 61 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 34 | 34 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 25 | 14 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 25 | 25 | $0 |
| 81003 | Automated urinalysis test | 17 | 17 | $0 |
Insurance plans in this area (ZIP 87015)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | UT | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | NM | |
| Physician Assistant | NM | |
| Physician Assistant | NM | |
| Family Practice, Sports Medicine | NM | |
| Nurse Practitioner | NM | |
| Physician Assistant | NM | |
| Physician Assistant | NM | |
| Nurse Practitioner | NM |
Reviews
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