THOMAS J RUDOLPH (PA-C) – Physician Assistant, NPI 1225365687
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for THOMAS J RUDOLPH (PA-C)
PO BOX 1188
CORVALLIS, OR 973391188
Phone:
Type: Mailing
1700 Geary St SE
Albany, OR 973226842
Phone: (541) 812-5500
Type: Location
Eugene Urgent Care, 1800, Coburg Road, Eugene, Lane County, Oregon, 97476, United States
EUGENE, OR 974014995
Phone: (541) 345-8760
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: 2012-01-03
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 |
|---|---|---|---|---|
| I20120103000776 | I | Physician Assistant | OR | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 87 | 81 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 30 | 30 | $0 |
| G0008 | Administration of influenza virus vaccine | 25 | 25 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 25 | 25 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 23 | 23 | $0 |
Insurance plans in this area (ZIP 97339)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MT | 81002 | Urinalysis, manual test | 23 | 22 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Nurse Practitioner | TX | |
| Family Practice | OR | |
| Physician Assistant | TN | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | NY | |
| - | OR | |
| Physician Assistant | OR | |
| - | OR |
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