Andy J Ruder, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2468035 Issued in WI

Practice address

16315 W Sentinal Rock LN
Surprise, AZ 85387-2765

Phone

(715) 214-8453

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment NPD
• MCHS Hospitals Inc

  • Clinic/Center
  • Eau Claire, WI
  • NPI 1316416035
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1700971082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16315 W SENTINAL ROCK LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853872765",
            "telephone_number": "715-214-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16315 W SENTINAL ROCK LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853872765",
            "telephone_number": "715-214-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDER",
        "first_name": "ANDY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-09-26",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2468035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38585600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Royulty by Dezign LLC
• Brylee Rozon
• Ashley Rubenstein, PT, DPT
• Porter Rubio
• Shaun M Ruckman, PT
• Sara Ruggles
• Hector Carlos Ruiz
• Faith Runion
• Deborah Kathleen Rupae, FNP
• Brock Terry Russell, DMD

• Optometrist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.