Individual provider Active NPI

Ragna C. Rostad-Ruffner, P.A.

  • Physician Assistant
  • Grants Pass, OR
National Provider Identifier
1124214382
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA219283 Issued in OR
Practice address
1890 NW 6TH St
Grants Pass, OR 97526-1038
Phone
(541) 507-0684
NPI assigned
Sep 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA19364 CA
Physician Assistant 363A00000X PA219283 OR Primary

Addresses

Primary practice location

1890 NW 6TH St
Grants Pass, OR 97526-1038

Mailing address

1531 Esplanade
Attn: Finance
Chico, CA 95926-3310
Phone (530) 332-7479

Other identifiers 1

IdentifierTypeStateIssuer
PA19364OtherCAPHYSICIAN ASSIST LICENSE

Other names 1

  • Ragna C. Ruffner Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250117002626 OR Practitioner - Physician Assistant 9032207527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

1841 E Barnett Rd
Medford, OR 97504-8249
Phone (541) 216-7291

1890 NW 6TH St
Grants Pass, OR 97526-1038
Phone (541) 507-0684

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19364CAMDSpeech-Language Pathologist
PA19364CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Nov 16, 2024 Accepting new patients
Enloe Medical Center Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Mission Ranch Primary Care Inc Past Accepting new patients
Icco, LLC Past Accepting new patients

Locations

600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBDAAA

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1124214382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "address_2": "ATTN: FINANCE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-7479",
            "fax_number": "530-893-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 NW 6TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261038",
            "telephone_number": "541-507-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTAD-RUFFNER",
        "first_name": "RAGNA",
        "middle_name": "C.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19364",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA219283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSIST LICENSE",
            "identifier": "PA19364",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAGNA",
            "last_name": "RUFFNER",
            "middle_name": "C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.