Individual provider Active NPI

Ruth Nyamoita Volkenant, PA

  • Physician Assistant
  • Santa Rosa, CA
National Provider Identifier
1174277842
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60406 Issued in CA
Practice address
2308 Roburta LN
Santa Rosa, CA 95403-1862
Phone
(612) 298-6095
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60406 CA Primary

Addresses

Primary practice location

2308 Roburta LN
Santa Rosa, CA 95403-1862

Mailing address

2308 Roburta LN
Santa Rosa, CA 95403-1862
Phone (612) 298-6095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240409003676 CA Practitioner - Physician Assistant 2466890470 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2308 Roburta LN
Santa Rosa, CA 95403-1862

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60406CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Scog Physician Assistant Corporation Current Accepting new patients
Scog Physician Assistant Corporation Current Accepting new patients

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 5

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1174277842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 ROBURTA LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031862",
            "telephone_number": "612-298-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 ROBURTA LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031862",
            "telephone_number": "612-298-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLKENANT",
        "first_name": "RUTH",
        "middle_name": "NYAMOITA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.