NPIMap

Individual provider Active NPI

Richard Michael Rucker, M.D.

  • Internal Medicine Physician
  • Los Alamitos, CA
National Provider Identifier
1659477685
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G61070 Issued in CA
Practice address
10931 Cherry St
Suite 300
Los Alamitos, CA 90720-2445
Phone
(562) 596-2246
Fax
(562) 799-0845
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G61070 CA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X G61070 CA
Pulmonary Disease Physician 207RP1001X G61070 CA

Addresses

Primary practice location

10931 Cherry St
Suite 300
Los Alamitos, CA 90720-2445

Mailing address

10931 Cherry St
Suite 300
Los Alamitos, CA 90720-2445
Phone (562) 596-2246

Other identifiers 1

IdentifierTypeStateIssuer
00G610700MedicaidCA

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
I20040302000422 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 6608762356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3801 Katella Ave
Suite 430
Los Alamitos, CA 90720-6902
Phone (562) 596-2246

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.32 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
74.41

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Los Alamitos Pulmonary Medical Associates Inc Pulmonary Disease CurrentSince Oct 17, 2003 Accepting new patients
James D. Leo, M.D., Inc. Internal Medicine Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Premier Medical Care, Inc. Internal Medicine Past Accepting new patients

Locations

3801 Katella Ave
Ste 430
Los Alamitos, CA 90720
Phone (562) 431-5000

10931 Cherry St
Ste 300
Los Alamitos, CA 90720
Phone (562) 493-1011

Organizations & group practices 4

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 6

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1659477685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10931 CHERRY ST",
            "address_2": "SUITE 300",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202445",
            "telephone_number": "562-596-2246",
            "fax_number": "562-799-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10931 CHERRY ST",
            "address_2": "SUITE 300",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202445",
            "telephone_number": "562-596-2246",
            "fax_number": "562-799-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G61070",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G61070",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G61070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G610700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.