Individual provider Active NPI

Stephen Paul Rucker, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1215394580
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 N Park St
Kalamazoo, MI 49007-3731
Phone
(269) 382-2500
NPI assigned
Jan 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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 MI Primary

Addresses

Primary practice location

200 N Park St
Kalamazoo, MI 49007-3731

Mailing address

200 N Park St
Kalamazoo, MI 49007-3731
Phone (269) 382-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160406000131 MI Practitioner - Physician Assistant 2567760689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 363-7272

1009 W Green St
Hastings, MI 49058-1710
Phone (616) 363-7272

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (616) 363-7272

14544 Georgian Bay Dr
Holland, MI 49424-7535
Phone (616) 363-7272

1855 Boardwalk
Saint Joseph, MI 49085-9664
Phone 61636372721046

1886 Sterling Oaks Blvd SE
Ada, MI 49301-9284
Phone (616) 363-7272

1987 Navaho TRL
Okemos, MI 48864-2721
Phone (616) 363-7272

2250 Anderson Dr SE
East Grand Rapids, MI 49506-4032
Phone (616) 363-7272

292 Yarmouth Rd
Bloomfield Hills, MI 48301-2745
Phone (616) 363-7272

300 N Ave
Battle Creek, MI 49017-3307
Phone (616) 363-7272

3121 Oak LN
Stevensville, MI 49127-9346
Phone (616) 363-7272

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone 61636372721046

3700 Lake Birch St NE
Grand Rapids, MI 49525-8606
Phone (616) 363-7272

408 Hazen St
Paw Paw, MI 49079-1019
Phone (616) 363-7272

524 S Park St
Kalamazoo, MI 49007-5118
Phone (616) 363-7272

5325 Ridge Rd
Stevensville, MI 49127-1000
Phone (616) 363-7272

6460 S Bluebird Ave E
Fremont, MI 49412-7660
Phone (616) 363-7272

6715 Apple Blossom LN
Kalamazoo, MI 49009-7488
Phone 61636373391046

859 Majestic
Rochester Hills, MI 48306-3574
Phone (616) 363-7272

9652 Maricopa TRL
Kalamazoo, MI 49009-4957
Phone (616) 363-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Cancer Center Physician Assistant CurrentSince Apr 1, 2016 Accepting new patients

Locations

200 N Park St
Kalamazoo, MI 49007
Phone (269) 373-7453

Organizations & group practices 3

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": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1215394580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "STEPHEN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.