Individual provider Active NPI

Robert D Rupprecht, DDS, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Paul, MN
National Provider Identifier
1336370444
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
37601 Issued in CA
Practice address
2500 Como Ave
Saint Paul, MN 55108-1460
Phone
(651) 647-2500
Fax
(651) 632-8984
NPI assigned
Aug 6, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 37601 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 37601 CA Primary

Addresses

Primary practice location

2500 Como Ave
Saint Paul, MN 55108-1460

Mailing address

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 647-2500

Other practice location 1

Uss Enterprise CVN-65
Dental, Box 48
Fpo, AE 09543-2810
Phone (757) 534-3734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000389 MN Practitioner - Oral Surgery 3072754399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Univ of Calif, San Francisco School of Dentistry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
37601CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Periodontics CurrentSince Jul 1, 2013 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. Periodontics CurrentSince Jul 1, 2013 Accepting new patients

Locations

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336370444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-647-2500",
            "fax_number": "651-632-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-647-2500",
            "fax_number": "651-632-8984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "USS ENTERPRISE CVN-65",
            "address_2": "DENTAL, BOX 48",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AE",
            "postal_code": "095432810",
            "country_code": "US",
            "telephone_number": "757-534-3734",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "RUPPRECHT",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "37601",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "37601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.