Kelly Ruiz, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1163512 Issued in CT

Practice address

21 Grand St
Hartford, CT 06106-1541

Phone

(860) 550-7500

NPI assigned

Jun 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Darshan J Shah MD LLCGroup PAC ID 0547300857, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.ruiz@2838.securemail.prognocis.com

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.

• Darshan J Shah MD LLC

  • Internal Medicine Physician
  • Enfield, CT
  • NPI 1366776775

  CT

  Medicare reassignment Care Compare group
• Charter Oak Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford, CT
  • NPI 1992750855

  CT

  Medicare reassignment NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215923131

  CT

  Medicare reassignment
• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683

  CT

  Medicare reassignment
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  CT

  Medicare reassignment
• Charter Oak Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford, CT
  • NPI 1841937679
  NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215518733
  NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vernon, CT
  • NPI 1669874855
  NPD
• Johnson Memorial Hospital, Inc.

  • Psychiatric Hospital Unit
  • Stafford Springs, CT
  • NPI 1053480293
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Johnson Memorial Hospital, Inc.

  • Psychiatric Hospital Unit
  • Stafford Springs, CT
  • NPI 1053480293

  Hospital

  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1932123569

  Hospital

  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1972728442

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1831758366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 KENT LN",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060021326",
            "telephone_number": "860-713-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061541",
            "telephone_number": "860-550-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "1163512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie J Rudnick, M.D.
• Richard T Ruffin Jr., M.D.
• Tonya Ruggieri, M.D.
• Erin Mary Ruggiero
• Carlos Ruiz Sr., LMSW
• Kevin Ruiz, MD
• Ricardo Ruiz, M.D.
• Michelle Rumery
• Sydney Rumplik, PHARMD, RPH
• Lily Dorothea Rundquist, DO

• All providers in Hartford, CT
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.