Individual provider Active NPI

Kadly K Ruder, DNP, APRN, AGNP-C

  • Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1396389037
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11003941 Issued in FL
Practice address
3838 N Campbell Ave
Tucson, AZ 85719-1454
Phone
(520) 694-2873
NPI assigned
Nov 6, 2019
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11003941 FL Primary
Adult Health Nurse Practitioner 363LA2200X APRN11003941 FL
Gerontology Nurse Practitioner 363LG0600X APRN11003941 FL
Primary Care Nurse Practitioner 363LP2300X APRN11003941 FL

Addresses

Primary practice location

3838 N Campbell Ave
Tucson, AZ 85719-1454

Mailing address

9613 S San Esteban Dr
Vail, AZ 85641-2079
Phone (520) 979-1316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20241125000786 AZ Practitioner - Nurse Practitioner 1052744695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11003941FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Dec 1, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Dec 1, 2024 Accepting new patients

Locations

1625 N Campbell Ave
Tucson, AZ 85719

1891 W Orange Grove Rd
Bldg 1
Tucson, AZ 85704
Phone (520) 694-2873

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

3838 N Campbell Ave
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1396389037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9613 S SAN ESTEBAN DR",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856412079",
            "telephone_number": "520-979-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191454",
            "telephone_number": "520-694-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDER",
        "first_name": "KADLY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11003941",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11003941",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11003941",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11003941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.