Active NPI
David Jay Ruckman, O.D.
- Optometrist
- Silverdale, WA
National Provider Identifier
1508298217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 767
- Practice address
- 10516 Silverdale Way NW
Silverdale, WA 98383-8745 - Phone
- (360) 307-7400
- Fax
- (877) 777-9902
- NPI assigned
- Aug 5, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 767 | NV | Primary |
Addresses
Primary practice location
10516 Silverdale Way NW
Silverdale, WA 98383-8745
Mailing address
5961 S Los Altos Pkwy
Ste 101
Sparks, NV 89436-2500
Phone (775) 359-2020
Other practice location 1
5961 S Los Altos Pkwy
Ste 101
Sparks, NV 89436-2500
Phone (775) 359-2020
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1508298217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5961 S LOS ALTOS PKWY",
"address_2": "STE 101",
"city": "SPARKS",
"state": "NV",
"postal_code": "894362500",
"telephone_number": "775-359-2020",
"fax_number": "775-359-2676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10516 SILVERDALE WAY NW",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838745",
"telephone_number": "360-307-7400",
"fax_number": "877-777-9902"
}
],
"practiceLocations": [
{
"address_1": "5961 S Los Altos Pkwy",
"address_2": "Ste 101",
"address_purpose": "LOCATION",
"city": "Sparks",
"state": "NV",
"postal_code": "894362500",
"country_code": "US",
"telephone_number": "775-359-2020",
"fax_number": "775-359-2676",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUCKMAN",
"first_name": "DAVID",
"middle_name": "JAY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-05",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "767",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10516 Silverdale Way NW",
"city": "Silverdale",
"state": "WA",
"country_code": "US",
"postal_code": "983838745",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.