Individual provider Active NPI

Kevin Lactaoen Ruaro

  • Family Medicine Physician
  • Burien, WA
National Provider Identifier
1376289819
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.MD.70097661 Issued in WA
Practice address
16110 8TH Ave SW Ste A2
Burien, WA 98166-2962
Phone
(206) 242-8280
Fax
(206) 242-8302
NPI assigned
May 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 77897 AZ
Family Medicine Physician 207Q00000X MD.MD.70097661 WA Primary
Family Medicine Physician 207Q00000X R79503 AZ

Addresses

Primary practice location

16110 8TH Ave SW Ste A2
Burien, WA 98166-2962

Mailing address

16110 8TH Ave SW Ste A2
Burien, WA 98166-2962
Phone (206) 242-8280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251202002572 AZ Practitioner - Family Practice 4284013921 Reassigns benefits to 1 organization
I20260526002455 WA Practitioner - Family Practice 4284013921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

16110 8TH Ave SW
Suite A2
Burien, WA 98166-2962
Phone (253) 426-4352

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.MD.70097661WAMDFamily Medicine Physician
77897AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Physician Group Holdings, LLC CurrentSince Nov 17, 2025 Accepting new patients

Locations

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

395 N Silverbell Rd
Ste 355
Tucson, AZ 85745
Phone (520) 622-5912

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/MmWbh382tKlbvAIA1_DeLlIjYVSwroch/

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1376289819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 8TH AVE SW STE A2",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662962",
            "telephone_number": "206-242-8280",
            "fax_number": "206-242-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 8TH AVE SW STE A2",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662962",
            "telephone_number": "206-242-8280",
            "fax_number": "206-242-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUARO",
        "first_name": "KEVIN",
        "middle_name": "LACTAOEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "77897",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD.MD.70097661",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R79503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.