Individual provider Active NPI

Andrew Cowles Rucker, D.O.

  • Child & Adolescent Psychiatry Physician
  • Longwood, FL
National Provider Identifier
1265965933
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
OS18946 Issued in FL
Practice address
555 W State Road 434
Longwood, FL 32750-5119
Phone
(407) 262-2220
Fax
(407) 834-5011
NPI assigned
Apr 9, 2017
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS18946 FL
Child & Adolescent Psychiatry Physician 2084P0804X OS18946 FL Primary

Addresses

Primary practice location

555 W State Road 434
Longwood, FL 32750-5119

Mailing address

555 W State Road 434
Longwood, FL 32750-5119
Phone (407) 262-2220

Other practice location 1

820 Prudential Dr Ste 510
Jacksonville, FL 32207-8207
Phone (904) 376-3800

Other practice location 2

400 E Sheridan Rd
Melbourne, FL 32901-3184
Phone (321) 722-5200

Other practice location 3

3015 N Ocean Blvd Ste C101
Fort Lauderdale, FL 33308-7300
Phone (754) 270-6322

Other practice location 4

8895 N Military Trl Ste 203C
West Palm Beach, FL 33410-6261
Phone (754) 270-6322

Other identifiers 1

IdentifierTypeStateIssuer
114552600MedicaidFL

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
I20220615000381 FL Practitioner - Psychiatry 7113306507 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Stop Psychiatry LLCGroup PAC ID 8426435470, 4 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

3015 N Ocean Blvd
Suite C101
Fort Lauderdale, FL 33308-7300
Phone (754) 270-6322

555 W State Rd
Suite 434
Longwood, FL 32750-5119
Phone (407) 237-6377

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Circles of Care, Inc. CurrentSince Aug 16, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2025 Accepting new patients
Circles of Care, Inc. CurrentSince Aug 16, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2025 Accepting new patients
Top Flight Psychiatry Psychiatry CurrentSince Jun 19, 2024 Accepting new patients
One Stop Medicine Inc CurrentSince Aug 10, 2025 Accepting new patients
One Stop Psychiatry LLC CurrentSince Mar 1, 2024 Accepting new patients
Youth Crisis Center, Inc. Past Accepting new patients

Locations

3015 N Ocean Blvd
Ste C101
Fort Lauderdale, FL 33308
Phone (754) 241-1087

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

400 Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5273

4450 W Eau Gallie Blvd
Melbourne, FL 32934
Phone (321) 255-6627

8910 Miramar Pkwy
Ste 309G
Miramar, FL 33025
Phone (305) 305-2326

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

2572 W State Road 426
Ste 2040
Oviedo, FL 32765
Phone (386) 479-1052

8895 N Military Trl
Ste 203C
West Palm Beach, FL 33410
Phone (754) 270-6322

Networks

  • Freedom Health HMO Network

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1265965933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505119",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505119",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Prudential Dr Ste 510",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078207",
            "country_code": "US",
            "telephone_number": "904-376-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 E Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013184",
            "country_code": "US",
            "telephone_number": "321-722-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 N Ocean Blvd Ste C101",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333087300",
            "country_code": "US",
            "telephone_number": "754-270-6322",
            "fax_number": "754-270-6321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8895 N Military Trl Ste 203C",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334106261",
            "country_code": "US",
            "telephone_number": "754-270-6322",
            "fax_number": "754-270-6321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "ANDREW",
        "middle_name": "COWLES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-09",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS18946",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "OS18946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114552600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.