Individual provider Active NPI

Rosalva Ruiz, P.A.-C

  • Physician Assistant
  • McAllen, TX
National Provider Identifier
1366685877
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05906 Issued in TX
Practice address
811 E Fern Ave Ste 1
McAllen, TX 78501-1401
Phone
(956) 630-2114
Fax
(956) 630-2155
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05906 TX Primary

Addresses

Primary practice location

811 E Fern Ave Ste 1
McAllen, TX 78501-1401

Mailing address

PO Box 4484
McAllen, TX 78502-4484
Phone (956) 630-2114

Other identifiers 1

IdentifierTypeStateIssuer
PA05906OtherTXPA LIC#

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110112000915 TX Practitioner - Physician Assistant 3779772330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05906TXMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366685877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4484",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785024484",
            "telephone_number": "956-630-2114",
            "fax_number": "956-630-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E FERN AVE STE 1",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785011401",
            "telephone_number": "956-630-2114",
            "fax_number": "956-630-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ROSALVA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LIC#",
            "identifier": "PA05906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.