Ryan Michael Luevanos, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A166859 Issued in CA

Practice address

1147 NW 64TH Ter
Terrace
Gainesville, FL 32605-4218

Phone

(352) 333-5168

NPI assigned

Apr 26, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Emergency Medicine

Education

Eastern Virginia Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Team Physicians of Southern California Medical Group IncGroup PAC ID 0446545354, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Team Physicians of Southern California Medical Group, Inc.

  • Emergency Medicine Physician
  • Oceanside, CA
  • NPI 1225499015
  Medicare reassignment Care Compare group
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  Care Compare affiliation

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1285169367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6134 AVENIDA CHAMNEZ",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377441",
            "telephone_number": "858-354-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 NW 64TH TER",
            "address_2": "TERRACE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-333-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEVANOS",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2021-12-06",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A166859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Norden Lucke, LCSW
• Jessica Ludlow
• Shelby L Lueders, PA-C
• Christine Luengo
• Charles W. Luetke, MD
• Daniel Omar Lugo Rodriguez, PHARMD
• Daphine Lugo, PSYD
• Edrei Lugo, CRNA
• Sylvia Nelida Lugo
• Julius Karolis Lukas, PHARMD

• Emergency Medicine Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.