Individual provider Active NPI

Ruben Berrocal Timmons, MD

  • Interventional Pain Medicine Physician
  • Gulf Breeze, FL
National Provider Identifier
1376546572
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME 42993 Issued in FL
Practice address
3406 Santa Rosa Dr
Gulf Breeze, FL 32563-5665
Phone
(850) 462-4544
Fax
(850) 777-3166
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X ME 42993 FL Primary

Addresses

Primary practice location

3406 Santa Rosa Dr
Gulf Breeze, FL 32563-5665

Mailing address

PO Box 30332
Pensacola, FL 32503-1332
Phone (850) 462-4544

Other practice location 1

1549 Airport Blvd Ste 440
Pensacola, FL 32504-8634
Phone (850) 462-4544

Other identifiers 1

IdentifierTypeStateIssuer
043027700MedicaidFL

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
I20040604000202 FL Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Pain Management 0648176644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Pain Management
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3406 Santa Rosa Dr
Gulf Breeze, FL 32563-5665
Phone (850) 462-4544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.28 of 100Reported as group
Quality
90.88
Improvement activities
40
Cost
73.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 42993FLMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Medicine and Pain Management Physicians PLLC Interventional Pain Medicine CurrentSince Mar 26, 2017 Accepting new patients
Interventional Rehabilitation Center, LLC Current Accepting new patients
Northwest Florida Anesthesia Consultants Inc Past Accepting new patients
Jacksonville Beaches Anesthesia Associates, Inc. PastSince May 7, 2023 Accepting new patients

Locations

3406 Santa Rosa Dr
Gulf Breeze, FL 32563
Phone (850) 462-4544

1645 Nantahala Beach Rd
Gulf Breeze, FL 32563
Phone (850) 438-1136

5330 N Davis Hwy
Pensacola, FL 32503
Phone (850) 469-2319

120 E Main St
Ste B
Pensacola, FL 32502
Phone (734) 389-5832

12385 Sorrento Rd
Ste D
Pensacola, FL 32507

1549 Airport Blvd
Ste 420
Pensacola, FL 32504
Phone (850) 484-8800

1549 Airport Blvd
Ste 440
Pensacola, FL 32504
Phone (850) 201-2418

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEDJAD/Endpoint/JEDJAD
  • Direct secure messaging: ruben.timmons.1@24700.direct.athenahealth.com

Organizations & group practices 4

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1376546572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30332",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031332",
            "telephone_number": "850-462-4544",
            "fax_number": "850-777-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 SANTA ROSA DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325635665",
            "telephone_number": "850-462-4544",
            "fax_number": "850-777-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1549 Airport Blvd Ste 440",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048634",
            "country_code": "US",
            "telephone_number": "850-462-4544",
            "fax_number": "850-462-5502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "RUBEN",
        "middle_name": "BERROCAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME 42993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043027700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.