Individual provider Active NPI

Timothy Kirk Ruttan, MD

  • Emergency Medicine Physician
  • Austin, TX
National Provider Identifier
1104080514
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P5885 Issued in TX
Practice address
Dell Children'S Emergency Department
4900 Mueller Blvd
Austin, TX 78723
Phone
(512) 324-9725
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X P5885 TX
Emergency Medicine Physician 207P00000X P5885 TX Primary

Addresses

Primary practice location

Dell Children'S Emergency Department
4900 Mueller Blvd
Austin, TX 78723

Mailing address

1345 Philomena St Ste 253
Austin, TX 78723-3210
Phone (512) 324-0150

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130724000530 TX Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 2163696725 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jun 1, 2017 Accepting new patients
Austin Critical Care Specialists PA CurrentSince Mar 1, 2020 Accepting new patients
Austin Critical Care Specialists PA CurrentSince Mar 1, 2020 Accepting new patients

Locations

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

4900 Mueller Blvd
#2
Austin, TX 78723

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

1751 Crystal Falls Pkwy
Leander, TX 78641
Phone (512) 528-7000

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

Organizations & group practices 3

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1104080514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 PHILOMENA ST STE 253",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233210",
            "telephone_number": "512-324-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DELL CHILDREN'S EMERGENCY DEPARTMENT",
            "address_2": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78723",
            "telephone_number": "512-324-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTAN",
        "first_name": "TIMOTHY",
        "middle_name": "KIRK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2025-05-06",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "P5885",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P5885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.