Individual provider Active NPI

Maria C Rucinski

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1396188835
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q5084 Issued in TX
Practice address
5201 Harry Hines Blvd
Graduate Medical Education
Dallas, TX 75235-7708
Phone
(214) 590-8058
NPI assigned
Apr 15, 2013
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X Q5084 TX Primary

Addresses

Primary practice location

5201 Harry Hines Blvd
Graduate Medical Education
Dallas, TX 75235-7708

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 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
I20160705001003 TX Practitioner - Emergency Medicine 5092007468 Reassigns benefits to 3 organizations
I20170711001356 FL Practitioner - Emergency Medicine 5092007468 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q5084TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Pediatric Emergency Medicine Group LLP Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Texas Physician Resources, LLP Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

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, 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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1396188835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "GRADUATE MEDICAL EDUCATION",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCINSKI",
        "first_name": "MARIA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q5084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.