Individual provider Active NPI

Antonio Ruiz Jr., PA

  • Physician Assistant
  • Plainview, TX
National Provider Identifier
1891071767
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1208 N Interstate 27
Plainview, TX 79072-3937
Phone
(806) 296-2444
NPI assigned
Oct 24, 2011
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

1208 N Interstate 27
Plainview, TX 79072-3937

Mailing address

1208 N Interstate 27
Plainview, TX 79072-3937
Phone (806) 296-2444

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ttustudenthealth@direct.myteamcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20120329000793 TX Practitioner - Physician Assistant 2860652716 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Feb 18, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Feb 18, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

4000 24th St
#410
Lubbock, TX 79410
Phone (806) 743-7700

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1891071767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 N INTERSTATE 27",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790723937",
            "telephone_number": "806-296-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 N INTERSTATE 27",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790723937",
            "telephone_number": "806-296-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ANTONIO",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttustudenthealth@direct.myteamcare.com",
            "affiliation": "N",
            "endpointDescription": "TTU Student Health Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1003 Flint Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794099803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plainview, TX

Sources for this page

Verify at the official NPI Registry.