NPIMap

Individual provider Active NPI

Grace Ruidera, M.D.

  • Specialist
  • Midwest City, OK
National Provider Identifier
1407886492
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
19279 Issued in OK
Practice address
111 N Post Rd
Suite C
Midwest City, OK 73130-3605
Phone
(405) 455-4342
Fax
(405) 455-4381
NPI assigned
Jul 4, 2006
Last updated
Nov 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19279 OK Primary

Addresses

Primary practice location

111 N Post Rd
Suite C
Midwest City, OK 73130-3605

Mailing address

PO Box 776066
Chicago, IL 60677-6066
Phone (405) 455-4342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000000 OK Practitioner - Internal Medicine 6507846847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

111 N Post Rd C
Mercy Clinic
Midwest City, OK 73130-3605
Phone (405) 455-4342

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19279OKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Sep 1, 2011 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients
Oklahoma Medical Specialists LLC Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

111 N Post Rd
Ste C
Midwest City, OK 73130
Phone (405) 455-4342

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Interoperability endpoints

  • Direct secure messaging: gruidera219597@directc.mercy.net

Organizations & group practices 5

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 10

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1407886492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776066",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776066",
            "telephone_number": "405-455-4342",
            "fax_number": "405-455-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N POST RD",
            "address_2": "SUITE C",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731303605",
            "telephone_number": "405-455-4342",
            "fax_number": "405-455-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIDERA",
        "first_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "19279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

Verify at the official NPI Registry.