Active NPI 1104182328 Individual Practitioner Female Practitioner

Dr. Carla Rudolph , DO

General Practice • Edgewood, NM

Professional Overview & Biography Verified Profile Summary

Dr. Carla Rudolph, DO is a registered healthcare professional specializing in General Practice in Edgewood, NM. Practice services are available at 1851 OLD US 66 under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, detection test by immunoassay with direct visual observation for influenza virus. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1851 Old Us 66

Edgewood, NM 870157200

Telephone 5052862396

Associated Practice Facility / Clinic

🏢 Sandia Mountain Medical, Inc. Facility NPI 1609885243

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Edgewood, NM

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 32.0 Yrs

Regional Practice Density

1 Specialists

Practicing in Edgewood, NM (115 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

51.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	63	61	$191.61	$116.73
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$302.23	$156.86
87804 Detection test by immunoassay with direct visual observation for influenza virus	25	14	$49.00	$16.22
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	25	25	$100.00	$34.62
81003 Automated urinalysis test	17	17	$22.00	$2.20
93000 Routine ekg using at least 12 leads including interpretation and report	16	16	$53.84	$13.72
71046 X-ray of chest, 2 views	14	14	$49.91	$31.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	388	64	$225.13	$60.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	312	126	$471.00	$122.26
99497 Advance care planning, first 30 minutes	68	68	$308.11	$81.71
G0442 Annual alcohol misuse screening, 5 to 15 minutes	65	65	$67.76	$17.51
G0444 Annual depression screening, 5 to 15 minutes	48	48	$67.76	$16.50
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	40	40	$479.96	$124.65
99457 Management using the results of remote vital sign monitoring per calendar month, first 20 minutes	40	16	$95.06	$46.78
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	38	19	$195.00	$45.91
99454 Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days	29	15	$100.04	$49.22
99442 Telephone medical discussion with physician, 11-20 minutes	26	22	$202.00	$86.80
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	19	19	$608.09	$160.67
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	18	14	$96.29	$25.65
99453 Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment	16	16	$34.30	$16.89
92550 Test for eardrum and muscle function	16	16	$81.48	$21.70
92552 Test for hearing various pitches using earphone	16	16	$117.99	$30.50
81003 Automated urinalysis test	15	13	$7.88	$2.22
93000 Routine ekg using at least 12 leads including interpretation and report	14	11	$53.80	$13.15
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$657.48	$175.27
99441 Telephone medical discussion with physician, 5-10 minutes	13	12	$140.00	$52.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	244	92	$211.00	$125.16
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	54	24	$99.82	$39.48
99497 Advance care planning, first 30 minutes	49	49	$172.76	$83.30
G0442 Annual alcohol misuse screening, 5 to 15 minutes	46	46	$37.38	$17.63
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	30	23	$285.00	$176.28
92552 Test for hearing various pitches using earphone	26	26	$60.00	$29.48
92550 Test for eardrum and muscle function	24	24	$42.00	$21.78
G0444 Annual depression screening, 5 to 15 minutes	23	23	$35.00	$17.63
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	19	19	$241.26	$127.93
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$353.94	$162.48
99213 Established patient office or other outpatient visit, typically 15 minutes	12	11	$143.00	$88.51
71046 X-ray of chest, 2 views	11	11	$58.00	$31.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	78	71	$149.36	$72.55
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	69	43	$211.23	$105.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	46	27	$285.91	$144.52
87804 Detection test by immunoassay with direct visual observation for influenza virus	38	22	$49.00	$16.22
71046 X-ray of chest, 2 views	29	28	$94.21	$29.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$218.50	$101.81
G0444 Annual depression screening, 5 to 15 minutes	22	22	$35.00	$16.84
G0442 Annual alcohol misuse screening, 5 to 15 minutes	20	20	$36.00	$17.64
99497 Advance care planning, first 30 minutes	19	19	$167.00	$85.86
81003 Automated urinalysis test	13	13	$18.46	$2.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	238	211	$152.16	$70.88
71046 X-ray of chest, 2 views	82	78	$100.00	$28.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	72	$227.00	$103.45
81003 Automated urinalysis test	69	63	$21.00	$2.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	49	49	$225.00	$103.37
93000 Routine ekg using at least 12 leads including interpretation and report	33	33	$80.00	$16.13
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	33	30	$8.00	$0.13
94640 Inhalation treatment for airway obstruction or sputum production	31	29	$50.00	$16.79
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	30	30	$306.00	$132.67
87804 Detection test by immunoassay with direct visual observation for influenza virus	26	15	$49.00	$16.22
80053 Blood test, comprehensive group of blood chemicals	25	24	$57.00	$11.51
85018 Blood count, hemoglobin	15	15	$18.00	$2.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	130	$219.00	$99.77
81003 Automated urinalysis test	33	31	$21.12	$2.71
71046 X-ray of chest, 2 views	32	32	$89.04	$27.74
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	31	30	$297.36	$133.48
93000 Routine ekg using at least 12 leads including interpretation and report	28	25	$79.57	$15.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$316.96	$152.43
G0008 Administration of influenza virus vaccine	12	12	$55.00	$19.38
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	12	12	$30.00	$23.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	151	131	$183.97	$98.88
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	145	145	$296.96	$153.00
81003 Automated urinalysis test	65	63	$22.00	$3.02
71020 X-ray of chest, 2 views, front and side	50	49	$101.69	$25.37
J0696 Injection, ceftriaxone sodium, per 250 mg	48	11	$14.00	$0.65
93000 Routine ekg using at least 12 leads including interpretation and report	32	32	$75.55	$15.56
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	28	28	$262.07	$133.73
36415 Insertion of needle into vein for collection of blood sample	26	26	$6.69	$2.94
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	21	15	$4.00	$0.05
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	21	21	$396.00	$192.20
94640 Inhalation treatment for airway obstruction or sputum production	20	20	$51.00	$16.25
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	19	18	$6.00	$0.15
85014 Red blood cell concentration measurement	18	16	$23.00	$3.18
80047 Blood test, basic group of blood chemicals (calcium, ionized)	16	16	$61.00	$11.37
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	15	13	$46.00	$22.93

Medical Specialties & State Licenses

CMS Verified: 2020-05-04

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License NM A-1770-13

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1104182328 (NC)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners

Dr. Alyssa Mirabal , MD

Family Medicine

NPI 1043773005

Doctor of Medicine (M.D.)

Ryan Grange , PA

Physician Assistant - Medical

NPI 1295194629

Physician Assistant

Dr. Harry Messec , MD

Family Medicine

NPI 1376512632

Doctor of Medicine (M.D.)

Kelly Ray , PA-C

Physician Assistant

NPI 1609182310

Physician Assistant (Certified)

Dr. Sanford Yankow , MD

Family Medicine

NPI 1699720714

Doctor of Medicine (M.D.)

Brian Ingram , PA

Physician Assistant

NPI 1700368495

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

📍

Updated Practice Location May 04, 2020

Registered at 1851 OLD US 66, EDGEWOOD, NM 870157200 (Tel: 5052862396)

📍

Updated Business Mailing Address May 04, 2020

Registered at 1851 OLD US 66, EDGEWOOD, NM 870157200 (Tel: 5052862396)

📍

Updated Practice Location June 15, 2018

Registered at 3762 DURHAM RD STE 100, ROXBORO, NC 27573 (Tel: 3363300400)

📍

Updated Business Mailing Address June 15, 2018

Registered at 3762 DURHAM RD STE 100, ROXBORO, NC 275732741 (Tel: 3363300400)

👤

Provider Name / Credentials Updated June 15, 2018

Recorded as CARLA RUDOLPH, DO

✅

NPI Profile Active April 29, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location April 29, 2014

Registered at 363 PINON CREEK RD SE, ALBUQUERQUE, NM 871233963 (Tel: 5406410271)

📍

Updated Business Mailing Address April 29, 2014

Registered at 363 PINON CREEK RD SE, ALBUQUERQUE, NM 871233963 (Tel: 5406410271)

👤

Provider Name / Credentials Updated April 29, 2014

Recorded as CARLA RUDOLPH, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2014

General Practice (License #A-1770-13 in NM)

🟢

Initial NPI Registration & Enumeration April 02, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1104182328

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 02, 2012

Last Update: May 04, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1851 Old Us 66

Edgewood, NM 870157200

Phone: 5052862396

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.