Dominick A Ruggiero, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002303 Issued in VA

Practice address

612 Kingsborough SQ Ste 100
Chesapeake, VA 23320-5041

Phone

(757) 547-9294

Fax

(757) 213-9342

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians

Sport Medicine and Orthopaedic Center IncGroup PAC ID 8921046616, 24 clinicians

Mid-Atlantic Post Acute and Long Term Care PLLCGroup PAC ID 0648530782, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24174/brand/1/csg/1/fhir/r4
• Direct secure messaging: dominick.ruggiero.1@24174.direct.athenahealth.com

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.

• Sport Medicine and Orthopaedic Center Inc

  • Orthopaedic Surgery Physician
  • Chesapeake, VA
  • NPI 1043246556

  Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Mid-Atlantic Post Acute & Long Term Care PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Norfolk, VA
  • NPI 1225557556
  Medicare reassignment Care Compare group
• Bayview Physician Services, PC

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1508813387
  Medicare reassignment NPD
• SE Virginia Value Based Care, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Norfolk, VA
  • NPI 1225720501
  Care Compare group
• Bayview Physician Services, PC

  dba LMC Radiology

  • Radiology Clinic/Center
  • Suffolk, VA
  • NPI 1699865626
  NPD
• Sports Medicine and Orthopaedic Center

  • Physical Therapist
  • Chesapeake, VA
  • NPI 1386303832
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sentara Hospitals

  dba Sentara Obici Hospital

  • General Acute Care Hospital
  • Suffolk, VA
  • NPI 1376540138
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1629094776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-547-9294",
            "fax_number": "757-213-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 KINGSBOROUGH SQ STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205041",
            "telephone_number": "757-547-9294",
            "fax_number": "757-213-9342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Old Donation Pkwy",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234543064",
            "country_code": "US",
            "telephone_number": "757-419-3000",
            "fax_number": "757-213-9377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Meade Pkwy",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234344259",
            "country_code": "US",
            "telephone_number": "757-934-9420",
            "fax_number": "757-934-9366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Brambleton Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235101151",
            "country_code": "US",
            "telephone_number": "757-627-7700",
            "fax_number": "757-627-3841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "DOMINICK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruetzel Gynecology & Obstetrics
• Craig H Ruetzel, M.D.
• Gillian G.P. Ruffin, RPH
• Tierra W Ruffin, LPC
• Wyatt M Ruffin Jr., DDS
• Kayla Ruiz
• Leigh Rumberger, LPC
• Amiyah Rumble
• Natalie Runser
• Michelle A Rusk, MS, CCC-SLP

• Physician Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.