Individual provider Active NPI

Temple S Rucker, MD

  • Diagnostic Radiology Physician
  • Omaha, NE
National Provider Identifier
1700921772
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4624 Issued in NE
Practice address
988095 Nebraska Medical Ctr
Omaha, NE 68198-8095
Phone
(402) 559-9800
NPI assigned
Feb 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4624 NE Primary

Addresses

Primary practice location

988095 Nebraska Medical Ctr
Omaha, NE 68198-8095

Mailing address

988095 Nebraska Medical Ctr
Omaha, NE 68198-8095
Phone (402) 559-9800

Other identifiers 1

IdentifierTypeStateIssuer
4624OtherNESTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20070611000495 NE Practitioner - Diagnostic Radiology 6103924410 Reassigns benefits to 2 organizations
I20260102000811 IA Practitioner - Diagnostic Radiology 6103924410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiologic Center IncGroup PAC ID 1759330731, 20 clinicians

Practice addresses (Care Compare)

Council Bluffs, IA 51503
Phone (402) 238-1539

4932 S 202 Ave
MPC North Streams
Omaha, NE 68135-3927
Phone (402) 815-7500

8019 Cass St
Omaha, NE 68114-3525
Phone (402) 390-0606

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-4344

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4624NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc CurrentSince Oct 1, 2023 Accepting new patients
Unmc Physicians Past Accepting new patients

Locations

717 N 190th Plz
Elkhorn, NE 68022
Phone (402) 815-1325

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

8019 Cass St
Omaha, NE 68114
Phone (402) 354-1250

8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000

625 S Pine St
Valley, NE 68064
Phone (402) 359-2277

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700921772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988095 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988095",
            "telephone_number": "402-559-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988095 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988095",
            "telephone_number": "402-559-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "TEMPLE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "4624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4624",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.