Individual provider Active NPI

Ronald Wayne Racca, MD

  • Orthopaedic Trauma Physician
  • Albuquerque, NM
National Provider Identifier
1508103268
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
74-226 Issued in NM
Practice address
12700 Calle del Oso PL NE
Albuquerque, NM 87111-8056
Phone
(505) 345-1789
Fax
(505) 344-7875
NPI assigned
Jan 14, 2013
Last updated
Jan 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 74-226 NM Primary

Addresses

Primary practice location

12700 Calle del Oso PL NE
Albuquerque, NM 87111-8056

Mailing address

12700 Calle del Oso PL NE
Albuquerque, NM 87111-8056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74-226NMMDOrthopaedic Trauma Physician

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1508103268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 CALLE DEL OSO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 CALLE DEL OSO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118056",
            "telephone_number": "505-345-1789",
            "fax_number": "505-344-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACCA",
        "first_name": "RONALD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NM",
            "license": "74-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.