Individual provider Active NPI

Ryan Rudloff, OD

  • Optometrist
  • Sioux City, IA
National Provider Identifier
1114419009
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
092394 Issued in IA
Practice address
431 Pierce St
Sioux City, IA 51101
Phone
(402) 770-3158
NPI assigned
Jun 5, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 092394 IA Primary

Addresses

Primary practice location

431 Pierce St
Sioux City, IA 51101

Mailing address

580 Dexter Dr Apt 206
McCook Lake, SD 57049-4056
Phone (402) 770-3158

Other practice location 1

305 Dakota Dunes Blvd
Dakota Dunes, SD 57049-5176
Phone (605) 232-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180822002261 IA Practitioner - Optometry 3476802539 Reassigns benefits to 1 organization
I20190415001798 SD Practitioner - Optometry 3476802539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Bruening PCGroup PAC ID 4284738378, 4 clinicians

Practice addresses (Care Compare)

101 Tower Rd
Suite 300
Dakota Dunes, SD 57049-5098

5500 Sergeant Rd
Suite 200
Sioux City, IA 51106-4716
Phone (605) 217-4500

600 N Sioux Point Rdsts
Dakota Dunes, SD 57049-5000
Phone 6052174500244500

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as group
Quality
98.67
Improvement activities
40
Cost
65.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Bruening PC Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Beth Bruening PC Optometrist CurrentSince Jul 1, 2020 Accepting new patients
TKC Optical, Inc. PastSince Jan 1, 2019 Accepting new patients
Hawkeye Exact, LLC Optometrist PastSince Jul 15, 2018 Accepting new patients

Locations

5500 Sergeant Rd
Ste 200
Sioux City, IA 51106
Phone (605) 217-4500

101 Tower Rd
Ste 300
North Sioux City, SD 57049
Phone (605) 217-4500

600 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-4320

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.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1114419009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 DEXTER DR APT 206",
            "city": "MCCOOK LAKE",
            "state": "SD",
            "postal_code": "570494056",
            "telephone_number": "402-770-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 PIERCE ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51101",
            "telephone_number": "402-770-3158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Dakota Dunes Blvd",
            "address_purpose": "LOCATION",
            "city": "Dakota Dunes",
            "state": "SD",
            "postal_code": "570495176",
            "country_code": "US",
            "telephone_number": "605-232-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDLOFF",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "092394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.