Individual provider Active NPI

Lizette Denise Ruiz, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1639512668
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A147989 Issued in CA
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(212) 746-0892
NPI assigned
Apr 9, 2013
Last updated
Jun 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A147989 CA Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

1229 E Susan Dr
Carson, CA 90745-1654
Phone (310) 897-7073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170724002325 CA Practitioner - Emergency Medicine 9739459769 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Southern California Keck School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Emergency Physicians IncGroup PAC ID 4981885951, 26 clinicians
Ignite Emergency Physicians a Medical CorporationGroup PAC ID 2365988326, 46 clinicians

Practice addresses (Care Compare)

1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 742-5555

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147989CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ignite Emergency Physicians a Medical Corporation CurrentSince Jul 1, 2025 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Golden State Emergency Physicians Inc Emergency Medicine CurrentSince Jun 1, 2017 Accepting new patients
Ridgeline Emergency Physicians Medical Group, Inc. Emergency Medicine CurrentSince Mar 12, 2025 Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

18300 Roscoe Blvd
Northridge, CA 91325
Phone (818) 885-5331

1801 W Olympic Blvd
#2611
Pasadena, CA 91199

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Organizations & group practices 5

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 2

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1639512668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E SUSAN DR",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907451654",
            "telephone_number": "310-897-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "LIZETTE",
        "middle_name": "DENISE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A147989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.