Individual provider Active NPI

Robert A Ruelaz, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Los Angeles, CA
National Provider Identifier
1881749026
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
A78097 Issued in CA
Practice address
4525 E Cesar E Chavez Ave
Los Angeles, CA 90022-1116
Phone
(818) 660-0778
Fax
(855) 578-3529
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X U0052 TX
Cardiovascular Disease Physician 207RC0000X U0052 TX
Cardiovascular Disease Physician 207RC0000X A78097 CA
Clinical Cardiac Electrophysiology Physician 207RC0001X U0052 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X A78097 CA Primary

Addresses

Primary practice location

4525 E Cesar E Chavez Ave
Los Angeles, CA 90022-1116

Mailing address

4525 E Cesar E Chavez Ave
Los Angeles, CA 90022-1116
Phone (818) 660-0778

Other practice location 1

707 E Marshall Ave
Longview, TX 75601-5545
Phone (903) 315-4880

Other practice location 2

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

Other identifiers 1

IdentifierTypeStateIssuer
1942505490MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IA, AZ3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20080128000319 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac Electrophysiology 5597847723 Reassigns benefits to 2 organizations
I20170531000058 IA Practitioner - Cardiovascular Disease (Cardiology) 5597847723 Reassigns benefits to 2 organizations
I20241107001803 AZ Practitioner - Cardiac ElectrophysiologyPractitioner - Internal Medicine 5597847723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Harvard Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

11865 Firestone Blvd
Norwalk, CA 90650-2902
Phone (877) 578-3529

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

250 S Crescent Dr
Mason City, IA 50401-2926

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

635 E US Hwy 9
Mercyone Forest City Family Medicine
Forest City, IA 50436-1028
Phone (641) 585-2904

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

  • Tranquility Care Hospice Inc Hospice, Glendale, CA, CCN A11552
  • Mercyone North Iowa Medical Center Hospital, Mason City, IA, CCN 160064
  • Community Hospital of Huntington Park Hospital, Huntington Park, CA, CCN 050091
  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063
  • Garfield Medical Center Hospital, Monterey Park, CA, CCN 050737

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78097CAMDCardiovascular Disease Physician
U0052TXMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Oct 4, 2024 Accepting new patients
Alegent Creighton Clinic Family Medicine Current Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince Oct 4, 2024 Accepting new patients
Long Life Cardiac Center Medical Corporation Cardiovascular Disease CurrentSince Jan 6, 2012 Accepting new patients
Alegent Creighton Clinic Family Medicine CurrentSince Feb 18, 2020 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics Family Medicine Current Accepting new patients
Dignity Health Past Accepting new patients
Covenant Medical Center Inc Past Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
CHHP Holdings II, LLC Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
North Iowa Mercy Clinics Internal Medicine Past Accepting new patients
Dignity Community Care Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Eladh, LP Past Accepting new patients
Mercy Medical Center Past Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001
Phone (928) 213-1051

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

35 S Garfield Ave
Alhambra, CA 91801
Phone (626) 458-8818

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rruelaz295606@christushealth.direct-ci.net
  • Direct secure messaging: rruelaz581248@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tranquility Care Hospice Inc.Glendale, CA, CCN A11552 Hospice Contracted Managing Employee
Operational/Managerial Control
Mar 1, 2025
Mar 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 9

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1881749026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221116",
            "telephone_number": "818-660-0778",
            "fax_number": "855-578-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 E CESAR E CHAVEZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221116",
            "telephone_number": "818-660-0778",
            "fax_number": "855-578-3529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015545",
            "country_code": "US",
            "telephone_number": "903-315-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 S Thompson St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860018759",
            "country_code": "US",
            "telephone_number": "928-226-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUELAZ",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U0052",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "U0052",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A78097",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "U0052",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A78097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942505490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.