Individual provider Active NPI

Todd Michael Ruttenberg, D.O.

  • Emergency Medicine Physician
  • Oceanside, CA
National Provider Identifier
1831401546
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A11991 Issued in CA
Practice address
4002 Vista Way
Oceanside, CA 92056-4506
Phone
(760) 724-8411
NPI assigned
Jul 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A11991 CA Primary
Emergency Medicine Physician 207P00000X S4676 TX

Addresses

Primary practice location

4002 Vista Way
Oceanside, CA 92056-4506

Mailing address

6092 Blue Dawn TRL
San Diego, CA 92130-6943
Phone (360) 551-1744

Other practice location 1

620 John Paul Jones Circle
Naval Medical Center - Portsmouth Internal Medicine
Portsmouth, VA 23708
Phone (757) 953-7001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 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
I20200721002983 TX Practitioner - Emergency Medicine 9335563535 Reassigns benefits to 2 organizations
I20220209001392 CA Practitioner - Emergency Medicine 9335563535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Webb Emergency Medicine Associates PAGroup PAC ID 1355305244, 43 clinicians

Practice addresses (Care Compare)

2901 Jaime Zapata Memorial Hwy
Laredo, TX 78043-5061
Phone (956) 523-2000

Hospital & facility affiliations

  • Doctors Hospital of Laredo Hospital, Laredo, TX, CCN 450643
  • Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128

Merit-based Incentive Payment System (MIPS)

Final score
94.06 of 100Reported as group
Quality
81.25
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11991CAMDAcupuncturist
20A11991CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Webb Emergency Medicine Associates PA Emergency Medicine CurrentSince Jun 15, 2020 Accepting new patients
McAdams Emergency Medicine Associates, PA Emergency Medicine CurrentSince Jun 15, 2020 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

2901 Jaime Zapata Memorial Hwy
Laredo, TX 78043
Phone (956) 718-9000

10700 McPherson Rd
Laredo, TX 78045
Phone (956) 523-2190

1300 E Saunders St
Laredo, TX 78041
Phone (956) 815-4470

Organizations & group practices 3

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 2

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": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1831401546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6092 BLUE DAWN TRL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306943",
            "telephone_number": "360-551-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564506",
            "telephone_number": "760-724-8411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Circle",
            "address_2": "Naval Medical Center - Portsmouth Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "23708",
            "country_code": "US",
            "telephone_number": "757-953-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTTENBERG",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A11991",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S4676",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.