Paul John Ruchalski Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

Evans Army Community Hospital USA Meddac
Diraimondo Family Medicine Clinic
Ft Carson, CO 80913-4604

Phone

(719) 524-2047

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902948656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 SEVENOAKS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809195410",
            "telephone_number": "719-599-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL USA MEDDAC",
            "address_2": "DIRAIMONDO FAMILY MEDICINE CLINIC",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCHALSKI",
        "first_name": "PAUL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Royce, OTR
• Nicholas Ruana, DMD
• Kenneth Charles Rubin
• Victor Manuel Rubio Villanueva, LCSW
• Elizabeth Ann Ruch, OTD, OTR/L
• Shirley Ann Rudd, LCSW
• Robert Steven Rudolphi, MD
• Daniel Ruiz
• Ashley Lynn Ruud, PHARMD
• Dawn Marie Ryan

• Physician Assistant in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.