Individual provider Active NPI

Rosa Ruggiero, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, OR
National Provider Identifier
1558524348
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201505448 Issued in OR
Practice address
730 Biddle Rd
Medford, OR 97504-6116
Phone
(541) 494-3800
Fax
(541) 494-0895
NPI assigned
Jul 2, 2008
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12515 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201505448 OR Primary

Addresses

Primary practice location

730 Biddle Rd
Medford, OR 97504-6116

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409003070 OR Practitioner - Nurse Practitioner 5698947497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1307 W Main St
Medford, OR 97501-2936
Phone (541) 618-1314

221 W Stewart Ave
Suite 101
Medford, OR 97501-3609
Phone (541) 690-3500

3617 S Pacific Hwy
Medford, OR 97501-8957
Phone (541) 535-6239

910 S Central Ave
Medford, OR 97501-7822
Phone (541) 618-1380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12515OHMDPsychiatric/Mental Health Nurse Practitioner
201505448ORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Apr 22, 2019 Accepting new patients
La Clinica del Valle Family Health Care Center Inc. CurrentSince Apr 22, 2019 Accepting new patients

Locations

3617 S Pacific Hwy
Medford, OR 97501
Phone (541) 512-3182

730 Biddle Rd
Medford, OR 97504
Phone (541) 494-3800

931 Chevy Way
Medford, OR 97504
Phone (541) 690-3555

Interoperability endpoints

  • Direct secure messaging: rruggiero276764@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1558524348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-690-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 BIDDLE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046116",
            "telephone_number": "541-494-3800",
            "fax_number": "541-494-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "ROSA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "12515",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201505448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.