Active NPI
Eduardo L Ricaurte, MD
- Obstetrics & Gynecology Physician
- Bettendorf, IA
National Provider Identifier
1285613422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 23724
- Practice address
- 4480 Utica Ridge Rd
Bettendorf, IA 52722-1644 - Phone
- (563) 355-9996
- Fax
- (563) 355-9997
- NPI assigned
- Jan 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 23724 | IA | Primary |
Addresses
Primary practice location
4480 Utica Ridge Rd
Bettendorf, IA 52722-1644
Mailing address
4480 Utica Ridge Rd
Bettendorf, IA 52722-1644
Phone (563) 355-9996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104554 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23724 | IA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1285613422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4480 UTICA RIDGE RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221644",
"telephone_number": "563-355-9996",
"fax_number": "563-355-9997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4480 UTICA RIDGE RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221644",
"telephone_number": "563-355-9996",
"fax_number": "563-355-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICAURTE",
"first_name": "EDUARDO",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-16",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IA",
"license": "23724",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104554",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.