Wilder Shawn Rucker, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

000-26-4414 Issued in NY

Practice address

3601 SW 160TH Ave Ste 250
Miramar, FL 33027-6314

Phone

(877) 866-7123

NPI assigned

Mar 1, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, TN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cedar Recovery Center of Middle Tennessee, LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Columbia, TN
  • NPI 1801345285
  Medicare reassignment NPD
• Empire Wound Physician Services, PLLC

  • General Practice Physician
  • Liberty, NY
  • NPI 1093130742
  Medicare reassignment NPD
• Pons Physician Services, PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Cortland, NY
  • NPI 1457732554

  Family Medicine

  Medicare reassignment NPD
• Renew Medical of New York, PLLC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1356979447

  Family Medicine

  Medicare reassignment NPD
• Cedar Recovery of Middle Tennessee, LLC

  • Clinic Pharmacy
  • Lebanon, TN
  • NPI 1497458111
  NPD
• Operation Par Inc

  • Community/Behavioral Health Agency
  • Clearwater, FL
  • NPI 1588724264
  NPD (past)
• Operation Par, Inc

  • Community/Behavioral Health Agency
  • Pinellas Park, FL
  • NPI 1669465639
  NPD (past)
• RNT Health Ventures LLC

  • Chiropractor
  • Hawthorne, NY
  • NPI 1689147274
  NPD (past)

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1235403742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 DEKALB AVE # 4A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112213204",
            "telephone_number": "718-490-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE STE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276314",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "WILDER",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "264414",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "000-26-4414",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "264414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Rosero
• Jeffrey Ross, RN/ACNP/CNS
• Jorge Antonio Rossello Jr., D.O.
• Michelle Elaine Rote, PHARMD
• Glen D Rowe, D.O.
• Ruddy a Valdes D.O., P.a.
• Christopher Gregg Rudolph, D.C.
• Amanda Rueda Diaz, BCBA
• Kristhel Fabiola Rugama
• Claudia Ruiz Armas

• General Practice Physician in Miramar, FL
• Providers in Miramar, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.