Ruby Pottukalam

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA057714 Issued in PA

Practice address

1648 Huntingdon Pike
Meadowbrook, PA 19046-8001

Phone

(215) 938-2100

NPI assigned

Nov 5, 2015

Last updated

Sep 25, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennsylvania Urgent Care Centers, PLLCGroup PAC ID 8123200631, 107 clinicians

Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Aria Health Physician Services

  dba Richboro Medical

  • Family Medicine Physician
  • Richboro, PA
  • NPI 1750949806
  Medicare reassignment Care Compare group
• Pennsylvania Urgent Care Centers, PLLC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Downingtown, PA
  • NPI 1902128721
  Medicare reassignment Care Compare group
• HR Physician Services

  dba HR Multispecialty Services

  • Obstetrics & Gynecology Physician
  • Meadowbrook, PA
  • NPI 1881696698
  Medicare reassignment
• Aria Health Physician Services

  dba Geoffrey W. Temple Family Medical Associates

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD
• Aria Health Physician Services

  dba Aria Allmed Urgent Care Center Street Road

  • Surgery Physician
  • Bensalem, PA
  • NPI 1437537792
  NPD
• HR Physician Services

  dba Emergency Medicine Phys Svcs

  • Emergency Medicine Physician
  • Meadowbrook, PA
  • NPI 1508868506
  NPD
• HR Physician Services

  dba Redeemer Health Infusion Therapy

  • Internal Medicine Physician
  • Huntingdon Valley, PA
  • NPI 1679450910
  NPD
• HR Physician Services

  dba Redeemer Physical Therapy at Richboro

  • Rehabilitation Clinic/Center
  • Richboro, PA
  • NPI 1730650151
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1417320920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 HUNTINGDON PIKE",
            "address_2": "MEDICAL STAFF OFFICE FIRST FLOOR",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468001",
            "telephone_number": "215-938-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 HUNTINGDON PIKE",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468001",
            "telephone_number": "215-938-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTUKALAM",
        "first_name": "RUBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003584",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Perechocky, M.D.
• Frank C Pessler, MD
• Mallory Smith Peterson, RD, LDN, CNSC, CDE
• Babak Salehi Pirouz, MD
• Perry S Pitkow, MD
• Kristen Pritch, CNIM
• Michelle C Quigel, CRNP
• Sumithra Reddy, PAC
• Redeemer Cancer Care Physicians Network, LLC
• Redeemer Health Anesthesia Associates, LLC

• Medical Physician Assistant in Meadowbrook, PA
• Providers in Meadowbrook, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.