Individual provider Active NPI

Ruby M Tucker, M.D.

  • Internal Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1194925545
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101225807 Issued in VA
Practice address
5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone
(757) 473-3969
Fax
(757) 506-0157
NPI assigned
Jul 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101225807 VA Primary

Addresses

Primary practice location

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629

Mailing address

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone (757) 473-3969

Other identifiers 1

IdentifierTypeStateIssuer
0101225807OtherVASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090203000701 VA Practitioner - Internal MedicinePractitioner - Family Practice 9032273149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Virginia Holding LLCGroup PAC ID 9537576608, 19 clinicians

Practice addresses (Care Compare)

5516 Virginia Beach Blvd
Virginia Beach, VA 23462-5629
Phone (757) 473-3969

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Feb 8, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

524 Southpark Blvd
Colonial Hgts, VA 23834
Phone (804) 504-7980

48 Newmarket Sq
Newport News, VA 23605
Phone (757) 825-8030

6550 Hull St Rd
Richmond, VA 23224
Phone (804) 674-3425

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

1712 E Broad St
Richmond, VA 23223
Phone (804) 344-9848

5516 Virginia Beach Blvd
Virginia Beach, VA 23462
Phone (757) 287-3699

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": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1194925545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969",
            "fax_number": "757-506-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625629",
            "telephone_number": "757-473-3969",
            "fax_number": "757-506-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "RUBY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101225807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0101225807",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.