Individual provider Active NPI

Nicholas Joseph Ruggiero II, M.D.

  • Interventional Cardiology Physician
  • Philadelphia, PA
National Provider Identifier
1669686978
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD424061 Issued in PA
Practice address
111 S 11TH St
Philadelphia, PA 19107-4824
Phone
(215) 955-5050
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD424061 PA
Cardiovascular Disease Physician 207RC0000X 25MA10128800 NJ
Interventional Cardiology Physician 207RI0011X 25MA10128800 NJ
Interventional Cardiology Physician 207RI0011X MD424061 PA Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4824

Mailing address

925 Chestnut Street
Mezzanine
Philadelphia, PA 19107-4201
Phone (215) 955-5050

Other practice location 1

925 Chestnut Street
Mezzanine
Philadelphia, PA 19107-4201
Phone (215) 955-5050

Other practice location 2

443 Laurel Oak Rd
Voorhees, NJ 08043-4419
Phone (215) 955-5050

Other identifiers 2

IdentifierTypeStateIssuer
1025095330001MedicaidPA
0241571MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, 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
I20101206000777 PA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Peripheral Vascular Disease 1355491200 Reassigns benefits to 1 organization
I20190507002458 NJ Practitioner - Cardiovascular Disease (Cardiology) 1355491200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Peripheral Vascular Disease
Education
Jefferson Medical College of Thomas Jefferson University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Mezzanine
Philadelphia, PA 19107-4290
Phone (215) 955-5050

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Aug 1, 2010 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. Cardiovascular Disease CurrentSince Mar 13, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

443 Laurel Oak Rd
Voorhees, NJ 08043
Phone (215) 456-4985

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

925 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-5050

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1101 Chestnut St
Fl 9
Philadelphia, PA 19107
Phone (215) 503-1807

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

1101 Chestnut St
#9
Philadelphia, PA 19107

111 S 11th St
Ste 6210
Philadelphia, PA 19107
Phone (215) 503-5151

Organizations & group practices 3

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1669686978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT STREET",
            "address_2": "MEZZANINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074201",
            "telephone_number": "215-955-5050",
            "fax_number": "215-955-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Chestnut Street",
            "address_2": "Mezzanine",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074201",
            "country_code": "US",
            "telephone_number": "215-955-5050",
            "fax_number": "215-955-7499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "443 Laurel Oak Rd",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434419",
            "country_code": "US",
            "telephone_number": "215-955-5050",
            "fax_number": "215-503-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD424061",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA10128800",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NJ",
            "license": "25MA10128800",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD424061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025095330001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0241571",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.