Active NPI
Martha Ruiz, FNP
- Family Nurse Practitioner
- Ontario, CA
National Provider Identifier
1316361355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 23283
- Practice address
- 3401 Centre Lake Dr Ste 512
Ontario, CA 91761-1201 - Phone
- (909) 566-0445
- NPI assigned
- Feb 11, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23283 | CA | Primary |
Addresses
Primary practice location
3401 Centre Lake Dr Ste 512
Ontario, CA 91761-1201
Mailing address
6630 Kaiser Ave
Fontana, CA 92336-3262
Phone (909) 714-0164
Other practice location 1
1800 Western Ave
San Bernardino, CA 92411-1356
Phone (909) 880-3677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23283 | CA | MD | Clinical Psychologist |
Interoperability endpoints
- mruiz@landmarkhealth-direct.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1316361355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6630 KAISER AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923363262",
"telephone_number": "909-714-0164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CENTRE LAKE DR STE 512",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917611201",
"telephone_number": "909-566-0445"
}
],
"practiceLocations": [
{
"address_1": "1800 Western Ave",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924111356",
"country_code": "US",
"telephone_number": "909-880-3677",
"fax_number": "909-880-3722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUIZ",
"first_name": "MARTHA",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-11",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "23283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.