Individual provider Active NPI

Ruidong Sun, MD

  • Anesthesiology Physician
  • Fort Wayne, IN
National Provider Identifier
1598897977
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01063317 Issued in IN
Practice address
700 Broadway
Fort Wayne, IN 46802-1402
Phone
(260) 969-1950
Fax
(260) 969-0988
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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 01063317 IN Primary

Addresses

Primary practice location

700 Broadway
Fort Wayne, IN 46802-1402

Mailing address

10351 Dawsons Creek Blvd
Suite D
Fort Wayne, IN 46825-1904
Phone (260) 969-1950

Other identifiers 3

IdentifierTypeStateIssuer
200856520MedicaidIN
000000511776OtherINANTHEM
P00379083OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NJ2 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
I20231012001091 CA Practitioner - Anesthesiology 3678679180 Reassigns benefits to 1 organization
I20241030001620 NJ Practitioner - Anesthesiology 3678679180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Morristown PAGroup PAC ID 7315906591, 168 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5539

Hospital & facility affiliations

  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115
  • Newton Medical Center Hospital, Newton, NJ, CCN 310028

Merit-based Incentive Payment System (MIPS)

Final score
67.76 of 100Reported as group
Quality
62.07
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.76 of 100Reported as group
Quality
78.69
Improvement activities
40
Cost
74.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01063317INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Sep 25, 2023 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Sep 25, 2023 Accepting new patients
Anesthesia Associates of Morristown PA CurrentSince Oct 1, 2024 Accepting new patients
Summit Anesthesia, LLC Anesthesiology Past Accepting new patients
Emergency Physicians of Indiana PC Past Accepting new patients
Cep America - Anesthesia PC Anesthesiology Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

111 Madison Ave
Morristown, NJ 07960
Phone (201) 943-5991

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1598897977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 DAWSONS CREEK BLVD",
            "address_2": "SUITE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251904",
            "telephone_number": "260-969-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BROADWAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021402",
            "telephone_number": "260-969-1950",
            "fax_number": "260-969-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "RUIDONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01063317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200856520",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000511776",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00379083",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.