Ruel T Miciano, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33300 Issued in MO

Practice address

702 Thunderbird Dr
Harrisonville, MO 64701-1558

Phone

(816) 380-4040

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Cass Medical Center

  • Psychiatric Hospital Unit
  • Harrisonville, MO
  • NPI 1912989351
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1871580654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 THUNDERBIRD DR",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647011558",
            "telephone_number": "816-380-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 THUNDERBIRD DR",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647011558",
            "telephone_number": "816-380-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICIANO",
        "first_name": "RUEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "33300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "599764206",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01249031",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meadow View Health & Rehabilitation LLC
• Medexa LLC
• Medi Trans
• Medright Consulting LLC
• Joyce Laurice Meeks, MS, LPC, NCC, BC-TMH
• Allissa Miller, PLPC
• Mindful Psychiatry LLC
• Missouri CVS Pharmacy LLC
• Missouri Emergency Medicine LLC
• Missouri Hearing Associate LLC

• Family Medicine Physician in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.