NPIMap

Individual provider Active NPI

Ronald J Ruby, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Manhattan Beach, CA
National Provider Identifier
1568475044
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
G34101 Issued in CA
Practice address
1101 N Sepulveda Blvd
Suite 102
Manhattan Beach, CA 90266-5948
Phone
(310) 545-6627
NPI assigned
Aug 14, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X G34101 CA Primary

Addresses

Primary practice location

1101 N Sepulveda Blvd
Suite 102
Manhattan Beach, CA 90266-5948

Mailing address

1101 N Sepulveda Blvd
Suite 102
Manhattan Beach, CA 90266-5948
Phone (310) 545-6627

Other identifiers 2

IdentifierTypeStateIssuer
GR0064100MedicaidCA
00G341010MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040301001177 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 2860387289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Laguna Niguel, CA 92677

520 N Prospect Ave
Redondo Beach, CA 90277-3042

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34101CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Endocrinology, Diabetes & Metabolism CurrentSince Aug 1, 2014 Accepting new patients
Providence Medical Institute Endocrinology, Diabetes & Metabolism Current Accepting new patients
Providence Medical Institute CurrentSince Aug 1, 2014 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 322-9700

1101 N Sepulveda Blvd
Ste 102
Manhattan Beach, CA 90266
Phone (310) 545-6627

520 N Prospect Ave
Ste 200
Redondo Beach, CA 90277
Phone (310) 374-7655

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1568475044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N SEPULVEDA BLVD",
            "address_2": "SUITE 102",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665948",
            "telephone_number": "310-545-6627",
            "fax_number": "310-545-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N SEPULVEDA BLVD",
            "address_2": "SUITE 102",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665948",
            "telephone_number": "310-545-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY",
        "first_name": "RONALD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "G34101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0064100",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G341010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

Verify at the official NPI Registry.