Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jesse Rudolph, DPT

Individual provider Physical Therapist · NPI 1346815826

Jesse Rudolph, DPT is a Physical Therapist in Private Practice in Pawtucket, Rhode Island. Qualified in 2020, 6 years ago. Practices with Silver Fern Practice LLC, a 296-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
6
Licensed in
RI
In the registry since
2021
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

21 Division St
Pawtucket, RI 02860-5352
Phone: (401) 726-7100
Fax: (401) 722-9386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT03389 (RI)

Record details

NPI number1346815826
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMay 26, 2021
Last updated in NPPESMay 26, 2021
Certification dateMay 26, 2021
Mailing address4 Richmond Sq Ste 200, Providence, RI 02906-5117

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Silver Fern Practice Llc — 296 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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