Active NPI
Katherine F Ruiz-de-Luzuriaga, M.D.
- Pediatric Infectious Diseases Physician
- Worcester, MA
National Provider Identifier
1487638516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- 58569
- Practice address
- 55 Lake Ave N
Department of Pediatric Immunology/Infectious Disease
Worcester, MA 01655-0002 - Phone
- (774) 442-3947
- Fax
- (774) 443-8733
- NPI assigned
- Dec 1, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 58569 | MA | |
| Pediatric Allergy/Immunology Physician | 2080P0201X | 58569 | MA | |
| Pediatric Infectious Diseases Physician | 2080P0208X | 58569 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Department of Pediatric Immunology/Infectious Disease
Worcester, MA 01655-0002
Mailing address
PO Box 415348
Boston, MA 02241-0001
Phone (800) 225-8885
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J0747601 | Other | MA | MEDICARE |
| 110045838A | Medicaid | MA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | kruizdeluzuriaga23653@UmassMemorial.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58569 | MA | MD | Pediatric Allergy/Immunology Physician |
Interoperability endpoints
- kruizdeluzuriaga23653@umassmemorial.direct-ci.com
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1487638516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022410001",
"telephone_number": "800-225-8885",
"fax_number": "508-334-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "DEPARTMENT OF PEDIATRIC IMMUNOLOGY/INFECTIOUS DISEASE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "774-442-3947",
"fax_number": "774-443-8733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ-DE-LUZURIAGA",
"first_name": "KATHERINE",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-01",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "58569",
"primary": false
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "MA",
"license": "58569",
"primary": false
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "MA",
"license": "58569",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "J0747601",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110045838A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"address_2": "Department of Pediatric Immunology/Infectious Disease",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kruizdeluzuriaga23653@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"address_2": "Department of Pediatric Immunology/Infectious Disease",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.