Individual provider Active NPI

Jose Israel Ruiz, M.D.

  • Emergency Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1215912829
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME78717 Issued in FL
Practice address
3287 Grouse Ave
Kissimmee, FL 34744-9281
Phone
(787) 525-6111
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12402 PR
Internal Medicine Physician 207R00000X ME78717 FL
Internal Medicine Physician 207R00000X 12402 PR
Emergency Medicine Physician 207P00000X ME78717 FL Primary

Addresses

Primary practice location

3287 Grouse Ave
Kissimmee, FL 34744-9281

Mailing address

3287 Grouse Ave
Kissimmee, FL 34744-9281
Phone (787) 525-6111

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
I20160317001617 FL Practitioner - Emergency MedicinePractitioner - General PracticePractitioner - Internal Medicine 4981927118 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93PRMDNaturopath
ME78717FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
Emergenciologos Para Puerto Rico,CSP Past Accepting new patients
Recinto de Ciencias Medicas Emergency Medicine Past Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1215912829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3287 GROUSE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347449281",
            "telephone_number": "787-525-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3287 GROUSE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347449281",
            "telephone_number": "787-525-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JOSE",
        "middle_name": "ISRAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "12402",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78717",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12402",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME78717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.