Individual provider Active NPI

Ruby Perocho, APRN, FNP

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1710758743
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-82712-081 Issued in KS
Practice address
7501 Metcalf Ave
Overland Park, KS 66204-2927
Phone
(913) 642-6330
NPI assigned
Jan 9, 2024
Last updated
Apr 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023047871 MO
Family Nurse Practitioner 363LF0000X 53-82712-081 KS Primary

Addresses

Primary practice location

7501 Metcalf Ave
Overland Park, KS 66204-2927

Mailing address

7501 Metcalf Ave
Overland Park, KS 66204-2927
Phone (913) 642-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240607002326 KS Practitioner - Nurse Practitioner 0840732632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

11729 Roe Ave
Leawood, KS 66211-2605
Phone (800) 389-2727

12290 College Blvd
Overland Park, KS 66210-4049
Phone (800) 389-2727

18351 W 119TH St
Olathe, KS 66061-8005
Phone (800) 389-2727

390 Limit St
Leavenworth, KS 66048-4525
Phone (866) 389-2727

7100 W 151St St
Overland Park, KS 66223-2232
Phone (800) 389-2727

7501 Metcalf Ave
Overland Park, KS 66204-2927
Phone (800) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-82712-081KSMDFamily Nurse Practitioner
2023047871MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince May 2, 2024 Accepting new patients
Signify Health Medical Associates of Kansas LLC CurrentSince May 1, 2024 Accepting new patients

Locations

11729 Roe Ave
Shawnee Mission, KS 66211
Phone (877) 646-2546

7501 Metcalf Ave
Shawnee Mission, KS 66204
Phone (913) 378-3542

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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

NPI Registry JSON

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1710758743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042927",
            "telephone_number": "913-642-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042927",
            "telephone_number": "913-642-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROCHO",
        "first_name": "RUBY",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023047871",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-82712-081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.