Individual provider Active NPI

Thomas B Ruffin Jr., M.D.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1205276789
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME127805 Issued in FL
Practice address
651 N Alafaya TRL
Orlando, FL 32828-7045
Phone
(407) 273-4132
Fax
(407) 332-5157
NPI assigned
Jun 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN18747 FL
Pediatrics Physician 208000000X ME127805 FL Primary

Addresses

Primary practice location

651 N Alafaya TRL
Orlando, FL 32828-7045

Mailing address

10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4100

Other identifiers 1

IdentifierTypeStateIssuer
017838200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180502000903 FL Practitioner - Pediatric Medicine 9234370255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of Central Florida LLPGroup PAC ID 1850296567, 132 clinicians

Practice addresses (Care Compare)

92 W Miller St
Orlando, FL 32806-2032
Phone (407) 648-7899

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME127805FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
Emergency Physicians of Central Florida LLP CurrentSince Jan 1, 2024 Accepting new patients
The Nemours Foundation CurrentSince Mar 21, 2018 Accepting new patients
The Nemours Foundation CurrentSince Mar 21, 2018 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

1001 E Osceola Pkwy
Kissimmee, FL 34744
Phone (321) 842-1270

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

575 W State Road 434
Longwood, FL 32750
Phone (321) 841-4514

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

1270 N Wickham Rd
Ste 50
Melbourne, FL 32935
Phone (321) 421-7588

11898 Lake Underhill Rd
Orlando, FL 32825
Phone (321) 841-4540

10155 Dowden Rd
Ste 301
Orlando, FL 32832

651 N Alafaya Trl
Orlando, FL 32828
Phone (407) 273-4132

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1205276789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4100",
            "fax_number": "904-697-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 N ALAFAYA TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287045",
            "telephone_number": "407-273-4132",
            "fax_number": "407-332-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "THOMAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN18747",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME127805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017838200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.