Individual provider Active NPI

Robert W Ruiz, P.A.

  • Emergency Medicine Physician
  • El Centro, CA
National Provider Identifier
1720147077
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PA15696 Issued in CA
Practice address
1415 Ross Avenue
El Centro, CA 99243-4306
Phone
(619) 660-1168
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PA15696 CA Primary

Addresses

Primary practice location

1415 Ross Avenue
El Centro, CA 99243-4306

Mailing address

PO Box 11179
Westminster, CA 92685-1179
Phone (888) 517-2788

Other identifiers 2

IdentifierTypeStateIssuer
PA15696MedicaidCA
1720147077MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040707001530 CA Practitioner - Physician Assistant 1759369796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocklin Family Practice and Sports MedicineGroup PAC ID 5395724777, 15 clinicians

Practice addresses (Care Compare)

3104 Sunset Blvd
Suite 2B
Rocklin, CA 95677-3093
Phone (916) 624-0300

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA15696CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rruiz235246@hisp.ehr.sutterhealth.org

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 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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1720147077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11179",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926851179",
            "telephone_number": "888-517-2788",
            "fax_number": "562-468-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ROSS AVENUE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "992434306",
            "telephone_number": "619-660-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "PA15696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA15696",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720147077",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.