Charles Ruegemer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12377 Issued in MN

Practice address

15245 Bluebird St NW
Andover, MN 55304-3538

Phone

(763) 587-4688

NPI assigned

Nov 28, 2015

Sex

Male

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 MN, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Select Urgent Care LLCGroup PAC ID 1658762646, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/28265/brand/1/csg/1/fhir/r4
• Direct secure messaging: charles.ruegemer.2@28265.direct.athenahealth.com

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  MN

  Medicare reassignment Care Compare group NPD
• Select Urgent Care LLC

  • Clinic/Center
  • Baxter, MN
  • NPI 1952063158

  MN

  Medicare reassignment Care Compare group NPD
• Mille Lacs Health System

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699

  MN

  Medicare reassignment
• Group Health Inc

  • Community/Retail Pharmacy
  • St Louis Park, MN
  • NPI 1104360973
  Care Compare group
• Group Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • St Louis Park, MN
  • NPI 1194886002
  Care Compare group
• Group Health, Inc.

  • Clinical Medical Laboratory
  • Eden Prairie, MN
  • NPI 1215048913
  Care Compare group
• Group Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Woodbury, MN
  • NPI 1386705291
  Care Compare group
• Group Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, MN
  • NPI 1619037660
  Care Compare group
• Group Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Saint Paul, MN
  • NPI 1689804064
  Care Compare group
• Group Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Apple Valley, MN
  • NPI 1801957717
  Care Compare group
• Group Health, Inc.

  • Community Based Hospice Care Agency
  • Bloomington, MN
  • NPI 1871534628
  Care Compare group
• Group Health, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Arden Hills, MN
  • NPI 1982764130
  Care Compare group

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

{
    "created_epoch": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1487028627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5745 YUCCA LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463532",
            "telephone_number": "612-702-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043538",
            "telephone_number": "763-587-4688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 3rd St NW",
            "address_purpose": "LOCATION",
            "city": "Elk River",
            "state": "MN",
            "postal_code": "553301445",
            "country_code": "US",
            "telephone_number": "763-587-4688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 109th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554494670",
            "country_code": "US",
            "telephone_number": "763-354-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2621 Greenhaven Rd",
            "address_purpose": "LOCATION",
            "city": "Anoka",
            "state": "MN",
            "postal_code": "553035566",
            "country_code": "US",
            "telephone_number": "763-587-4688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUEGEMER",
        "first_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-28",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06080",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Andover, MN
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.