Individual provider Active NPI

Benjamin Ruddick, M.D.

  • Anesthesiology Physician
  • Rancho Mirage, CA
National Provider Identifier
1487814299
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
C152316 Issued in CA
Practice address
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone
(760) 340-3911
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C152316 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221

Mailing address

PO Box 847969
Los Angeles, CA 90084-7969
Phone (626) 795-6596

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129002881 TX Practitioner - Anesthesiology 4385076215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Anesthesia Partners PLLCGroup PAC ID 4880072636, 58 clinicians

Practice addresses (Care Compare)

423 Treeline Park
Suite 202
San Antonio, TX 78209-2078
Phone (910) 949-6000

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Anesthesia Associates CurrentSince Jan 18, 2024 Accepting new patients
Lone Star Anesthesia Partners PLLC Anesthesiology CurrentSince Jan 1, 2024 Accepting new patients

Locations

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

423 Treeline Park
Ste 202
San Antonio, TX 78209
Phone (910) 949-6000

18600 Hardy Oak Blvd
San Antonio, TX 78258
Phone (210) 404-0800

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

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.

Hospital & facility affiliations 3

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1487814299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847969",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900847969",
            "telephone_number": "626-795-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-340-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDICK",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2021-12-01",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C152316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.