Individual provider Active NPI

Michael Ruderman, DO, MPH

  • Research Study Specialist
  • Oakland, CA
National Provider Identifier
1902259880
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Research Study SpecialistTaxonomy code 1744R1102X
Practice address
2940 Summit St Ste 2D
Oakland, CA 94609-3416
Phone
(858) 245-5644
Fax
(510) 571-3149
NPI assigned
Jul 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Research Study Specialist 1744R1102X Primary
Psychiatry Physician 2084P0800X 20A18101 CA

Addresses

Primary practice location

2940 Summit St Ste 2D
Oakland, CA 94609-3416

Mailing address

2940 Summit St Ste 2D
Oakland, CA 94609-3416
Phone (858) 245-5644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A18101CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1902259880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST STE 2D",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "858-245-5644",
            "fax_number": "510-571-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST STE 2D",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "858-245-5644",
            "fax_number": "510-571-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDERMAN",
        "first_name": "MICHAEL",
        "credential": "DO, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A18101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.