Edwin Ruiz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60640291 Issued in WA

Practice address

413 29TH St NE Ste I
Puyallup, WA 98372-7154

Phone

(855) 255-1750

Fax

(855) 255-0905

NPI assigned

Jun 30, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• United Wound Healing PS

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Puyallup, WA
  • NPI 1669845327
  Medicare reassignment
• United Wound Healing Accountable Care Consultants PLLC

  • Surgery Physician
  • Puyallup, WA
  • NPI 1881337632

  Physician Assistant

  NPD

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1326499443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 29TH ST NE STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983727154",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 29TH ST NE STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983727154",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "EDWIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60640291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Leanne Ruchalski, LMP
• Rebecca Sara Rucker, DPT, OCS, CSCS
• Rudd Vision PLLC
• Jay Charles Rudd, MD
• Rauna Ruhser, CCC-SLP
• Rachel Elizabeth Running, PT
• Scott Runyon, PT, DPT
• Brenda Darlene Russell-Hospenthal, LMP
• Andrea Russell
• Don R Russell, D.O.

• Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.

Verify at the official NPI Registry.