Individual provider Active NPI

Tim Franklin Ruark Jr., MD

  • Surgery Physician
  • Tallahassee, FL
National Provider Identifier
1699877852
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0066328 Issued in FL
Practice address
1401 Centerville Rd Ste G02
Tallahassee, FL 32308-4638
Phone
(850) 433-1210
Fax
(850) 431-2199
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0066328 FL Primary

Addresses

Primary practice location

1401 Centerville Rd Ste G02
Tallahassee, FL 32308-4638

Mailing address

1401 Centerville Rd Ste G02
Tallahassee, FL 32308-4638
Phone (850) 433-1210

Other identifiers 1

IdentifierTypeStateIssuer
375634300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111109000151 FL Practitioner - General Surgery 8527231448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

1775 One Healing PL
Tallahassee, FL 32308-4600
Phone (850) 431-5360

Hospital & facility affiliations

  • Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66328FLMDPharmacist
ME0066328FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients

Locations

555 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 431-5360

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

Interoperability endpoints

  • Direct secure messaging: truark22276@tallahasseememorial.direct-ci.com
  • Direct secure messaging: timruark@tmhpp.allscriptsdirect.net

Organizations & group practices 2

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 1

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1699877852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE G02",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-433-1210",
            "fax_number": "850-431-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE G02",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-433-1210",
            "fax_number": "850-431-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUARK",
        "first_name": "TIM",
        "middle_name": "FRANKLIN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0066328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375634300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.