Individual provider Active NPI

Roque Ruggero, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Round Rock, TX
National Provider Identifier
1497713101
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
L0556 Issued in TX
Practice address
2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone
(512) 341-1000
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X L0556 TX Primary
Emergency Medicine Physician 207P00000X L0556 TX

Addresses

Primary practice location

2400 Round Rock Ave
Round Rock, TX 78681-4004

Mailing address

5102 Ridgemoor Dr
Austin, TX 78731-4734
Phone (512) 323-0069

Other identifiers 1

IdentifierTypeStateIssuer
142017602MedicaidTX

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
I20071126000196 TX Practitioner - Emergency Medicine 0749378933 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L0556TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Feb 15, 2015 Accepting new patients
Capitol City Emergency Staffing PA Emergency Medical Services Past Accepting new patients

Locations

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

12813 Galleria Cir
Bee Cave, TX 78738
Phone (512) 816-2100

1020 S State Highway 16
Fredericksburg, TX 78624
Phone (830) 990-1555

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1497713101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 RIDGEMOOR DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314734",
            "telephone_number": "512-323-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814004",
            "telephone_number": "512-341-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGERO",
        "first_name": "ROQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "L0556",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L0556",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142017602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.