Individual provider Active NPI

Raymond S Ruzicano, M.D.

  • Psychiatry Physician
  • Walnut Creek, CA
National Provider Identifier
1811062508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G33140 Issued in CA
Practice address
112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3091
Phone
(925) 943-1400
Fax
(925) 946-1463
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

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
Psychiatry Physician 2084P0800X G33140 CA Primary

Addresses

Primary practice location

112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3091

Mailing address

112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3091
Phone (925) 943-1400

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050819000672 CA Practitioner - Psychiatry 5799715660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northwestern University Feinberg Medical School, 1975
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

112 La Casa Via
Suite 345
Walnut Creek, CA 94598-3002
Phone (925) 943-1400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raymond S. Ruzicano, M.D.Inc Psychiatry CurrentSince Sep 3, 2012 Accepting new patients

Locations

112 La Casa Via
Ste 345
Walnut Creek, CA 94598
Phone (925) 943-1400

Organizations & group practices 1

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811062508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "SUITE 345",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-943-1400",
            "fax_number": "925-946-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LA CASA VIA",
            "address_2": "SUITE 345",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983091",
            "telephone_number": "925-943-1400",
            "fax_number": "925-946-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZICANO",
        "first_name": "RAYMOND",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G33140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.