Individual provider Active NPI

Angalesia Rucker, NP-C

  • Women's Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1376953489
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
COA.15837-NP Issued in OH
Practice address
12000 Shaker Blvd
Cleveland, OH 44120-1922
Phone
(216) 472-3216
NPI assigned
Apr 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.15837-NP OH
Gerontology Nurse Practitioner 363LG0600X COA.15837-NP OH
Primary Care Nurse Practitioner 363LP2300X COA.15837-NP OH
Women's Health Nurse Practitioner 363LW0102X COA.15837-NP OH Primary
Nurse Practitioner 363L00000X COA.15837-NP OH
Community Health Nurse Practitioner 363LC1500X COA.15837-NP OH

Addresses

Primary practice location

12000 Shaker Blvd
Cleveland, OH 44120-1922

Mailing address

12000 Shaker Blvd
Cleveland, OH 44120-1922
Phone (216) 313-7583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20161219001616 OH Practitioner - Nurse Practitioner 8729369327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rakesh Ranjan M.D. and Assoc., IncGroup PAC ID 6507895067, 22 clinicians

Practice addresses (Care Compare)

801 E Washington St
Suite 150
Medina, OH 44256-3336
Phone 21658767273402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.15837-NPOHMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Nov 1, 2018 Accepting new patients
Rakesh Ranjan M.D. & Assoc., Inc. CurrentSince Oct 7, 2019 Accepting new patients
The Metrohealth System CurrentSince Nov 1, 2018 Accepting new patients
Rakesh Ranjan MD & Associates, Inc. CurrentSince Oct 7, 2019 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

12395 McCracken Rd
Ste H
Garfield Hts, OH 44125
Phone (216) 504-3646

801 E Washington St
Ste 150
Medina, OH 44256
Phone (330) 722-1069

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.

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1376953489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 SHAKER BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201922",
            "telephone_number": "216-313-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 SHAKER BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201922",
            "telephone_number": "216-472-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "ANGALESIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.15837-NP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "COA.15837-NP",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "COA.15837-NP",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "COA.15837-NP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.15837-NP",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "OH",
            "license": "COA.15837-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.