Individual provider Active NPI

Tara Lynn Ruberg, M.D.

  • Obstetrics & Gynecology Physician
  • Boca Raton, FL
National Provider Identifier
1225397847
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME143781 Issued in FL
Practice address
6859 SW 18TH St
Ste 200
Boca Raton, FL 33433-7015
Phone
(561) 368-3775
Fax
(561) 392-7139
NPI assigned
May 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME143781 FL Primary
Obstetrics & Gynecology Physician 207V00000X MD458251 PA

Addresses

Primary practice location

6859 SW 18TH St
Ste 200
Boca Raton, FL 33433-7015

Mailing address

6859 SW 18TH St
Ste 200
Boca Raton, FL 33433-7015
Phone (561) 368-3775

Other identifiers 1

IdentifierTypeStateIssuer
103133077MedicaidPA

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
I20210309002299 FL Practitioner - Obstetrics/Gynecology 3173774056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rush Medical College of Rush University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

6853 SW 18TH St
Suite 301
Boca Raton, FL 33433-7056
Phone (561) 368-3775

7545 W Boyton Beach Blvd
101 Women'S Health Partners LLC
Boynton Beach, FL 33437-6167
Phone (561) 734-5710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME143781FLMDObstetrics & Gynecology Physician
MD458251PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Jan 4, 2021 Accepting new patients
Womens Healthcare Assoc PA Obstetrics & Gynecology Past Accepting new patients

Locations

6859 SW 18th St
Ste 200
Boca Raton, FL 33433
Phone (561) 368-3775

7545 Boynton Beach Blvd
Ste 101
Boynton Beach, FL 33437

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

Organizations & group practices 2

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 3

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": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1225397847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6859 SW 18TH ST",
            "address_2": "STE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334337015",
            "telephone_number": "561-368-3775",
            "fax_number": "561-392-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 SW 18TH ST",
            "address_2": "STE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334337015",
            "telephone_number": "561-368-3775",
            "fax_number": "561-392-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBERG",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-12-13",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME143781",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD458251",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103133077",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.