Ruth Wessen Stefanos

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q9746 Issued in TX

Practice address

609 Medical Center Dr # 2218
Decatur, TX 76234-3836

Phone

(940) 626-2718

Fax

(940) 626-1320

NPI assigned

Apr 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1194757369

  TX

  Medicare reassignment NPD
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD
• Wise Clinical Care Associates

  • Urgent Care Clinic/Center
  • Haslet, TX
  • NPI 1386112506
  NPD (past)

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1093158370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 MEDICAL CENTER DR # 2218",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343836",
            "telephone_number": "940-626-2718",
            "fax_number": "940-626-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANOS",
        "first_name": "RUTH",
        "middle_name": "WESSEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q9746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093158370",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8KE37",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sports Healthcare Centers, Inc.
• Zuleima Stansell
• Heather Nicole Stark, FNP-C
• Stay Strong Solution, LLC
• Jori Steele
• Thomas Edward Steffen, MD
• Donna Jeanne Stowers, RPH
• Strategic Care of Decatur, LLC
• Melissa Marie Stroud, M.D.
• Gita Devi Subedi, FNP

• Pediatrics Physician in Decatur, TX
• Providers in Decatur, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.