Individual provider Active NPI

Alan Patrick Ruiz, MD

  • Family Medicine Physician
  • Danielson, CT
National Provider Identifier
1407099484
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53155 Issued in CT
Practice address
45 Green Hollow Rd
Danielson, CT 06239-3509
Phone
(860) 774-1255
Fax
(860) 779-2059
NPI assigned
Apr 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53155 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

45 Green Hollow Rd
Danielson, CT 06239-3509

Mailing address

45 Green Hollow Rd
Danielson, CT 06239-3509
Phone (860) 774-1255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160413000343 CT Practitioner - Family Practice 4385861426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians

Practice addresses (Care Compare)

45 Green Hollow Rd
Danielson, CT 06239-3509
Phone (860) 774-1255

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Day Kimball Medical Group Inc Family Medicine CurrentSince Jan 31, 2016 Accepting new patients

Locations

132 Westminster Rd
Canterbury, CT 06331
Phone (860) 546-2225

45 Green Hollow Rd
Danielson, CT 06239
Phone (860) 774-1255

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

7 Kennedy Dr
Putnam, CT 06260
Phone (860) 928-7704

Interoperability endpoints

  • Direct secure messaging: alan.ruiz.1@1694.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

Organizations & group practices 1

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 4

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1407099484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-774-1255",
            "fax_number": "860-779-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-774-1255",
            "fax_number": "860-779-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ALAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "53155",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.