Colby Samuelson Ruiz, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

100304 Issued in GA

Practice address

2409 N Patterson St Ste 230
Valdosta, GA 31602-2512

Phone

(229) 259-4369

NPI assigned

Apr 11, 2019

Last updated

Jun 19, 2024By the provider in NPPES

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 names 1

• Michael Colby Samuelson-Ruiz Former name

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Vascular Surgery

Education

University of North Carolina at Chapel Hill School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122
• SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csamuelsonruiz129175@directhisp.wakemed.org

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.

• SGMC Physician Network Inc

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1417597170
  Medicare reassignment Care Compare group NPD
• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  NPD
• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553

  Student in an Organized Health Care Education/Training Program

  NPD (past)

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

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation
• South Georgia Medical Center Inc

  dba SGMC Health Lanier

  • Critical Access Hospital
  • Lakeland, GA
  • NPI 1215703632
  Care Compare affiliation

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1891258257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 N PATTERSON ST STE 230",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022512",
            "telephone_number": "229-259-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 N PATTERSON ST STE 230",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022512",
            "telephone_number": "229-259-4369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "919-966-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "COLBY",
        "middle_name": "SAMUELSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "100304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "SAMUELSON-RUIZ",
            "middle_name": "COLBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janis Rowland
• Tasha Royal
• McKenzi Royals, CF-SLP
• Ivie Rozier, PHARM D
• Leslie Ann Ruff, LMSW
• Allison Leigh-Smith Rupp, DO
• Rural Urgent Care LLC (MainStreet Family Care)
• Angela Russell
• Erin Russo
• Paige Lillian Russo

• Vascular Surgery Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.