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

MS. Mary Rudloff, PA-C

Individual provider Physician Assistant · NPI 1407841356

MS. Mary Rudloff, PA-C is a Physician Assistant in Fredonia, New York. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 1986, 40 years ago. Practices with Great Lakes Physician Practice PC, a 143-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
40
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
NY
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

12 Center St Ste 1
Fredonia, NY 14063-1769
Phone: (716) 679-2233
Fax: (716) 679-9698
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 005154 (NY)

Record details

NPI number1407841356
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 16, 2005
Last updated in NPPESJanuary 25, 2024
Certification dateJuly 12, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 1986 (40 years in practice)
Group practice Great Lakes Physician Practice Pc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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