DR. JASON BALTAR RODULFA (MD) – Neuroradiology Physician, NPI 1891102620
Neuroradiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,576 DIAGNOSTIC RADIOLOGY in PA
Provider Addresses for DR. JASON BALTAR RODULFA (MD)
5501 OLD YORK ROAD
ALBERT EINSTEIN MEDICAL CENTER
PHILADELPHIA, PA 19141
Phone:
Type: Mailing
PO BOX 11137
CHARLESTON, WV 253391137
Phone: (304) 344-3457
Fax: (304) 344-3480
Type: Mailing
1120 KANAWHA BLVD E
CHARLESTON, WV 253012400
Phone: (304) 344-3457
Fax: (304) 344-3480
Type: Location
25 Jacobs Gulch Rd
Kellogg, ID 838372023
Phone: (208) 784-1221
Fax: (208) 784-0961
Type: Location
700 W IRONWOOD DR STE 175
COEUR D ALENE, ID 838144401
Phone: (208) 625-6309
Fax: (208) 625-6310
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: 2025-10-03
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 |
|---|---|---|---|---|
| I20200820002885 | I | Diagnostic Radiology | WV | TBD |
| I20230919003407 | I | Diagnostic Radiology | ID | TBD |
| I20251003000672 | I | Diagnostic Radiology | LA | 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 |
|---|---|---|---|---|
| 70450 | Ct scan head or brain without contrast | 372 | 356 | $0 |
| 71045 | X-ray of chest, 1 view | 184 | 162 | $0 |
| 72141 | Mri scan of upper spinal canal without contrast | 95 | 95 | $0 |
| 70498 | Ct scan of blood vessels of neck with contrast | 88 | 88 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 84 | 82 | $0 |
Insurance plans in this area (ZIP 19141)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | ID | |
| Nurse Practitioner | ID | |
| Nurse Practitioner | ID | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | ID | |
| Orthopedic Surgery | ID | |
| Family Practice | WA | |
| Diagnostic Radiology | ID | |
| Internal Medicine | ID | |
| - | ID |
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