Individual provider Active NPI

Rukmini Poruri, MD

  • Anesthesiology Physician
  • Merced, CA
National Provider Identifier
1568420685
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A36385 Issued in CA
Practice address
301 E 13TH Street
Merced, CA 95340
Phone
(209) 385-7087
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A36385 CA Primary

Addresses

Primary practice location

301 E 13TH Street
Merced, CA 95340

Mailing address

PO Box 7096
Stockton, CA 95267
Phone (209) 956-7725

Other identifiers 3

IdentifierTypeStateIssuer
00A363850MedicaidCA
P00375747OtherCARAILROAD MEDICARE
00A363850OtherCABLUE SHIELD OF CA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A36385CAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1568420685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95267",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 13TH STREET",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95340",
            "telephone_number": "209-385-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORURI",
        "first_name": "RUKMINI",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A36385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A363850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00375747",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00A363850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.