Individual provider Active NPI

Robert Edward Rupp, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Stateline, NV
National Provider Identifier
1558360628
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
8856 Issued in NV
Practice address
165 Highway 50
Stateline, NV 89449-9816
Phone
(775) 589-8950
Fax
(775) 588-1299
NPI assigned
Jul 20, 2005
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X A67307 CA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 8856 NV Primary

Addresses

Primary practice location

165 Highway 50
Stateline, NV 89449-9816

Mailing address

2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5659

Other practice location 1

935 Mica Dr Ste 13
Carson City, NV 89705-7181
Phone (775) 783-3065

Other practice location 2

2170B South Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080212000468 NV Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 9830272020 Reassigns benefits to 2 organizations
I20090501000440 CA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 9830272020 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

165 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8950

2170 B S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 539-6620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement35
Knee replacement12
Lower limb (leg) arthroscopy (minimally invasive joint repair)19
Upper limb (arm) arthroscopy (minimally invasive joint repair)51
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67307CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barton Healthcare System Current Accepting new patients
Barton Healthcare System CurrentSince Nov 1, 2017 Accepting new patients
Lake Tahoe Orthopaedic Institute, a Watson-Swanson Professional Corp Sports Medicine CurrentSince Jul 1, 1999 Accepting new patients
Lake Tahoe Orthopaedic Institute a Watson-Swanson Professional Corp CurrentSince Jul 1, 1999 Accepting new patients
Barton Medical Foundation CurrentSince Apr 1, 2025 Accepting new patients
Tahoe Orthopedics & Sports Medicine, Inc. Sports Medicine CurrentSince Jan 1, 2010 Accepting new patients
Barton Healthcare System Past Accepting new patients
Washoe Barton Medical Clinic a Nevada Nonprofit Corporation Past Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients
Tahoe Forest Hospital District Past Accepting new patients

Locations

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5659

1139 3rd St
South Lake Tahoe, CA 96150
Phone (530) 541-3100

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

2170 South Ave
#B
South Lake Tahoe, CA 96150
Phone (530) 539-6620

3860 Saddle Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5575

935 Mica Dr
Ste 13
Carson City, NV 89705
Phone (775) 783-3065

925 Tahoe Blvd
Ste 105
Incline Village, NV 89451
Phone (530) 543-5799

Interoperability endpoints

  • Direct secure messaging: rrupp65628@direct.renown.org

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 6

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1558360628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 HIGHWAY 50",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894499816",
            "telephone_number": "775-589-8950",
            "fax_number": "775-588-1299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "935 Mica Dr Ste 13",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897057181",
            "country_code": "US",
            "telephone_number": "775-783-3065",
            "fax_number": "775-267-1829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2170B South Ave",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961507026",
            "country_code": "US",
            "telephone_number": "530-543-5554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUPP",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A67307",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NV",
            "license": "8856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stateline, NV

Sources for this page

Verify at the official NPI Registry.