Individual provider Active NPI

Valentina Irene Ruzecki, M.D.

  • Pediatrics Physician
  • Puyallup, WA
National Provider Identifier
1750337150
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00041060 Issued in WA
Practice address
11102 Sunrise Blvd E
Suite 103
Puyallup, WA 98374
Phone
(253) 848-8797
Fax
(253) 845-0100
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00041060 WA Primary

Addresses

Primary practice location

11102 Sunrise Blvd E
Suite 103
Puyallup, WA 98374

Mailing address

11102 Sunrise Blvd E
Suite 103
Puyallup, WA 98374
Phone (253) 848-8797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 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
I20151217002648 VA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8123078797 Reassigns benefits to 1 organization
I20250409003341 NC Practitioner - Pediatric Medicine 8123078797 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Mar 4, 2025 Accepting new patients
Vidant Medical Group LLC CurrentSince Mar 4, 2025 Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Oct 19, 2015 Accepting new patients
Public Hospital District No. 4, King County Washington Pediatrics Past Accepting new patients
Public Hospital District No 4, King County Wa Pediatrics Past Accepting new patients
Pacific Palisades Podiatry PLLC Past Accepting new patients
Public Hospital District No 4 King County Washington Past Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1750337150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E",
            "address_2": "SUITE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E",
            "address_2": "SUITE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZECKI",
        "first_name": "VALENTINA",
        "middle_name": "IRENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00041060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.