Organization Active NPI

Casa Ruben Incorporated

  • Family Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1083332431
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CASA RUBEN INCORPORATED
Practice address
1700 Elton Rd Ste 200
Silver Spring, MD 20903-1766
Phone
(301) 445-2500
Fax
(301) 650-0606
NPI assigned
Aug 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Authorized official

Name
Ligia Peralta, MDNPI 1386687614
Title
President and Ceo
Phone
(301) 445-2500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X

Addresses

Primary practice location

1700 Elton Rd Ste 200
Silver Spring, MD 20903-1766

Mailing address

1700 Elton Rd Ste 200
Silver Spring, MD 20903-1766
Phone (301) 445-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221102001307 DC Part B Supplier - Clinic/Group Practice 3274900360 Receives reassigned benefits from 1 practitioner
Practice locations: Silver Spring, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2255206Casa Ruben Inc1700 Elton Road Suite 200, Silver Spring, MD 20903Certificate of waiverMar 10, 2028

National Provider Directory

National Provider Directory

Locations

1700 Elton Rd
Ste 200
Silver Spring, MD 20903
Phone (301) 445-2500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1083332431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ELTON RD STE 200",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031766",
            "telephone_number": "301-445-2500",
            "fax_number": "301-650-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ELTON RD STE 200",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031766",
            "telephone_number": "301-445-2500",
            "fax_number": "301-650-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA RUBEN INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "PERALTA",
        "authorized_official_first_name": "LIGIA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "301-445-2500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.