Individual provider Active NPI

Rudy Manuel Ramirez, PA-C

  • Medical Physician Assistant
  • Corona, CA
National Provider Identifier
1457660359
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20540 Issued in CA
Practice address
13355 Green Mountain Dr
Corona, CA 92883-6229
Phone
(951) 258-4089
NPI assigned
Sep 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20540 CA Primary

Addresses

Primary practice location

13355 Green Mountain Dr
Corona, CA 92883-6229

Mailing address

7300 Magnolia Ave
Riverside, CA 92504-3810
Phone (951) 710-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140730001681 CA Practitioner - Physician Assistant 1355567165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.8 of 100Reported as group
Quality
100
Improvement activities
40
Cost
65.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20540CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Pain Management Medical Group PC PastSince Feb 11, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1457660359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043810",
            "telephone_number": "951-710-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 GREEN MOUNTAIN DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836229",
            "telephone_number": "951-258-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "RUDY",
        "middle_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.