Individual provider Active NPI

Phillip N Ruhl, DO

  • Anesthesiology Physician
  • Stockton, CA
National Provider Identifier
1033295316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A4481 Issued in CA
Practice address
525 W Acacia St
Stockton, CA 95203-2405
Phone
(209) 944-5550
NPI assigned
Oct 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A4481 CA Primary

Addresses

Primary practice location

525 W Acacia St
Stockton, CA 95203-2405

Mailing address

PO Box 7156
Stockton, CA 95267-0156
Phone (209) 467-6866

Other identifiers 1

IdentifierTypeStateIssuer
00AX48810MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728000581 CA Practitioner - Anesthesiology 0042248346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
College of Osteo Med of the Pacific at Pomona, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A4481CAMDAnesthesiology Physician
4881CAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

521 S Ham Ln
Lodi, CA 95242
Phone (209) 333-0905

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

1805 N California St
Ste 405
Stockton, CA 95204
Phone (209) 870-7100

2388 N California St
Stockton, CA 95204
Phone (209) 465-2711

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033295316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7156",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670156",
            "telephone_number": "209-467-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W ACACIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032405",
            "telephone_number": "209-944-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUHL",
        "first_name": "PHILLIP",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A4481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX48810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.