Individual provider Active NPI

John Edward Ruelas, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1134624356
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T1193 Issued in TX
Practice address
5820 E Sam Houston Pkwy N
Houston, TX 77049-2500
Phone
(713) 442-6000
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T1193 TX Primary

Addresses

Primary practice location

5820 E Sam Houston Pkwy N
Houston, TX 77049-2500

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-4997

Other identifiers 1

IdentifierTypeStateIssuer
427194201MedicaidTX

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
I20210722002092 TX Practitioner - Family Practice 0042613432 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T1193TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Family Medicine CurrentSince Aug 16, 2021 Accepting new patients

Locations

5820 E Sam Houston Pkwy N
Houston, TX 77049
Phone (713) 442-6000

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

8233 N Sam Houston Pkwy E
Humble, TX 77396
Phone (713) 442-2000

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

Organizations & group practices 1

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": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1134624356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 E SAM HOUSTON PKWY N",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770492500",
            "telephone_number": "713-442-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUELAS",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T1193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427194201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.