Individual provider Active NPI

Theresa Voissem Ruano, DO

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1578694824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
058461 Issued in FL
Practice address
5707 N 22ND Street
Mental Health Care Inc
Tampa, FL 33610
Phone
(813) 272-2878
Fax
(813) 272-3766
NPI assigned
Mar 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 058461 FL Primary

Addresses

Primary practice location

5707 N 22ND Street
Mental Health Care Inc
Tampa, FL 33610

Mailing address

5707 N 22ND Street
Mental Health Care Inc
Tampa, FL 33610
Phone (813) 272-2878

Other identifiers 2

IdentifierTypeStateIssuer
265060600MedicaidFL
15838OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110527000456 FL Practitioner - PsychiatryPractitioner - Osteopathic Manipulative Medicine 8325225402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Osteopathic Manipulative Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ibis Healthcare IncGroup PAC ID 2769469204, 24 clinicians

Practice addresses (Care Compare)

5707 - N 22ND St
Tampa, FL 33610-4350
Phone (813) 239-8069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
058461FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ibis Healthcare Inc CurrentSince Apr 23, 2002 Accepting new patients
Ibis Healthcare Inc CurrentSince Apr 23, 2002 Accepting new patients

Locations

2208 E Henry Ave
Tampa, FL 33610
Phone (813) 239-2882

5707 N 22nd St
Tampa, FL 33610
Phone (813) 272-2244

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578694824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 N 22ND STREET",
            "address_2": "MENTAL HEALTH CARE INC",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "813-272-2878",
            "fax_number": "813-272-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND STREET",
            "address_2": "MENTAL HEALTH CARE INC",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "813-272-2878",
            "fax_number": "813-272-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUANO",
        "first_name": "THERESA",
        "middle_name": "VOISSEM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "058461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265060600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "15838",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.