Individual provider Active NPI

Renuka Tania Rudra, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Oxnard, CA
National Provider Identifier
1033640313
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A175678 Issued in CA
Practice address
2221 Wankel Way
Oxnard, CA 93030-0192
Phone
(805) 988-9366
Fax
(805) 483-3747
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A175678 CA Primary

Addresses

Primary practice location

2221 Wankel Way
Oxnard, CA 93030-0192

Mailing address

1203 Flynn Rd Unit 160
Camarillo, CA 93012-6203
Phone (805) 804-4168

Other practice location 1

137 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-5707
Phone (805) 379-4574

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
I20221013002729 CA Practitioner - Physical Medicine and Rehabilitation 3870912983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Pennsylvania State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Pain Management Medical Group IncGroup PAC ID 0547252918, 42 clinicians

Practice addresses (Care Compare)

450 N Wiget LN
Walnut Creek, CA 94598-2408
Phone (925) 482-8151

454 N Wiget LN
Walnut Creek, CA 94598-2408
Phone (925) 482-8111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A175678CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Management Medical Group, Inc. CurrentSince Aug 29, 2022 Accepting new patients
Trias Global, LLC Past Accepting new patients

Locations

1701 Solar Dr
Ste 140
Oxnard, CA 93030
Phone (805) 278-4148

999 N Tustin Ave
Ste 201
Santa Ana, CA 92705
Phone (714) 975-7950

450 N Wiget Ln
Walnut Creek, CA 94598
Phone (925) 413-4960

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1033640313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 FLYNN RD UNIT 160",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930126203",
            "telephone_number": "805-804-4168",
            "fax_number": "805-830-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 WANKEL WAY",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930300192",
            "telephone_number": "805-988-9366",
            "fax_number": "805-483-3747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 E Thousand Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913605707",
            "country_code": "US",
            "telephone_number": "805-379-4574",
            "fax_number": "805-379-4324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDRA",
        "first_name": "RENUKA",
        "middle_name": "TANIA",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A175678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.