Individual provider Active NPI

Rulon Deem Beesley, M.D.

  • Ophthalmology Physician
  • Lancaster, CA
National Provider Identifier
1902892441
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G63031 Issued in CA
Practice address
44404 16TH St W
Suite 102
Lancaster, CA 93534-2839
Phone
(661) 940-0555
Fax
(661) 940-0558
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G63031 CA Primary

Addresses

Primary practice location

44404 16TH St W
Suite 102
Lancaster, CA 93534-2839

Mailing address

44404 16TH St W
Suite 102
Lancaster, CA 93534-2839
Phone (661) 940-0555

Other identifiers 1

IdentifierTypeStateIssuer
00G630311MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63031CAMDPharmacist
G63031CAMDOphthalmology Physician

Organizations & group practices 2

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1902892441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44404 16TH ST W",
            "address_2": "SUITE 102",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342839",
            "telephone_number": "661-940-0555",
            "fax_number": "661-940-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44404 16TH ST W",
            "address_2": "SUITE 102",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342839",
            "telephone_number": "661-940-0555",
            "fax_number": "661-940-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEESLEY",
        "first_name": "RULON",
        "middle_name": "DEEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G63031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G630311",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.