Individual provider Active NPI

Brandon Alden Edward Ruen, MD

  • Family Medicine Physician
  • Naples, FL
National Provider Identifier
1316438542
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-11205 Issued in IA
Practice address
4513 Executive Dr Ste 101
Naples, FL 34119-9033
Phone
(239) 594-7563
Fax
(239) 594-5637
NPI assigned
May 23, 2018
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-11205 IA Primary

Addresses

Primary practice location

4513 Executive Dr Ste 101
Naples, FL 34119-9033

Mailing address

4724 N Davis Hwy
Pensacola, FL 32503-2339
Phone (850) 696-4000

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
I20210719001203 FL Practitioner - Family Practice 1557619582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Korunda Medical, LLCGroup PAC ID 5092895334, 7 clinicians

Practice addresses (Care Compare)

4513 Executive Dr
Suite 101
Naples, FL 34119-9033
Phone (239) 591-2803

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-11205IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Korunda Medical, LLC Family Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

26741 Dublin Woods Cir
Bonita Springs, FL 34135
Phone (239) 449-7979

4513 Executive Dr
Naples, FL 34119
Phone (239) 431-6464

4513 Executive Dr
Ste 101
Naples, FL 34119
Phone (239) 594-7563

4513 Executive Dr
Ste 201
Naples, FL 34119
Phone (239) 624-0470

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1316438542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032339",
            "telephone_number": "850-696-4000",
            "fax_number": "850-607-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 EXECUTIVE DR STE 101",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341199033",
            "telephone_number": "239-594-7563",
            "fax_number": "239-594-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEN",
        "first_name": "BRANDON",
        "middle_name": "ALDEN EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.