Paul Edgar Runge, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

19486 Issued in TN

Practice address

13411 Blythefield Ter
Lakewood Ranch, FL 34202-2456

Phone

(941) 894-4400

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• SK Retina LLC

  • Retina Specialist (Ophthalmology) Physician
  • Sarasota, FL
  • NPI 1194170779
  NPD (past)
• Livefreely Inc

  • Public Health or Welfare Agency
  • San Jose, CA
  • NPI 1023689973
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1881691335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13411 BLYTHEFIELD TER",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022456",
            "telephone_number": "941-894-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13411 BLYTHEFIELD TER",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022456",
            "telephone_number": "941-894-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4820 Harwood Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951245273",
            "country_code": "US",
            "telephone_number": "408-981-5577",
            "fax_number": "669-234-4118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNGE",
        "first_name": "PAUL",
        "middle_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME58780",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A39159",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A39159",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "19486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0805726",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/FL",
            "identifier": "31874",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379992100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL",
            "identifier": "3488212-001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0401145",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "ME0058780",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO, MC, EC",
            "identifier": "4197868",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0927003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Roth, PSY. D.
• Nataliia Rotner, DMD
• Nicholas George Rowe, BS DC
• Brent Lane Rubin, DPM
• Brandy Rubinski, DMD
• Kateryna Rusin, M.D
• Christine Nichole Ryan, PTA
• Christine M Rykiel, LCSW
• Sage Dental of Lakewood Ranch at Natures Way PLLC
• Sage Dental of Lakewood Ranch PLLC

• Ophthalmology Physician in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.