Organization Active NPI

Erica M Ruiz MD Professional

  • Family Medicine Physician
  • La Quinta, CA
National Provider Identifier
1306092465
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A104555 Issued in CA
Legal business name
ERICA M RUIZ MD PROFESSIONAL
Practice address
47110 Washington St Ste 203
La Quinta, CA 92253-2186
Phone
(760) 564-9205
Fax
(760) 771-6243
NPI assigned
Aug 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Authorized official

Name
Dr. Erica Michelle Ruiz, MDNPI 1215191184
Title
MD
Phone
(760) 564-9205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A104555 CA Primary

Addresses

Primary practice location

47110 Washington St Ste 203
La Quinta, CA 92253-2186

Mailing address

47110 Washington St Ste 203
La Quinta, CA 92253-2186
Phone (760) 564-9205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081216000363 CA Part B Supplier - Clinic/Group Practice 6901968528 Receives reassigned benefits from 2 practitioners
Practice locations: La Quinta, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1103601Erica M Ruiz, MD Prof Corp47110 Washington St Ste 203, La Quinta, CA 92253Certificate of waiverNov 6, 2026

National Provider Directory

National Provider Directory

Locations

47110 Washington St
Ste 203
La Quinta, CA 92253
Phone (760) 564-9205

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1306092465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47110 WASHINGTON ST STE 203",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532186",
            "telephone_number": "760-564-9205",
            "fax_number": "760-771-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47110 WASHINGTON ST STE 203",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532186",
            "telephone_number": "760-564-9205",
            "fax_number": "760-771-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA M RUIZ MD PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "760-564-9205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A104555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.