Octavia S Ruelas, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

76315 Issued in MN

Practice address

640 Jackson St
Saint Paul, MN 55101-2502

Phone

(651) 254-3456

NPI assigned

May 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Lakeview Memorial Hospital Association Inc.

  • Neonatal Nurse Practitioner
  • Stillwater, MN
  • NPI 1821114729

  Emergency Medicine

  Medicare reassignment NPD
• Regions Hospital

  • Emergency Medicine Physician
  • Saint Paul, MN
  • NPI 1154359917
  Medicare reassignment NPD
• Amery Regional Medical Center, Inc.

  • Critical Access Hospital
  • Amery, WI
  • NPI 1093763518
  Medicare reassignment NPD
• Hudson Hospital, Inc.

  • Critical Access Hospital
  • Hudson, WI
  • NPI 1396849303
  Medicare reassignment NPD
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Medicare reassignment NPD
• Westfields Hospital, Inc.

  • Critical Access Hospital
  • New Richmond, WI
  • NPI 1881640183
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Lakeview Memorial Hospital Association Inc

  • Pharmacy
  • Stillwater, MN
  • NPI 1326124454
  NPD
• Regions Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105
  NPD
• Regions Hospital

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1134157092
  NPD
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Clear Lake, WI
  • NPI 1366878449
  NPD
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Luck, WI
  • NPI 1851345268
  NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1922673938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Stageline Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 Churchill St W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826605",
            "country_code": "US",
            "telephone_number": "651-430-4529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 Griffin St E",
            "address_purpose": "LOCATION",
            "city": "Amery",
            "state": "WI",
            "postal_code": "540011439",
            "country_code": "US",
            "telephone_number": "715-268-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WI",
            "postal_code": "540171449",
            "country_code": "US",
            "telephone_number": "715-243-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUELAS",
        "first_name": "OCTAVIA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "83764",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "76315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen James Rudolph, MD
• Erin Caroline Ruecker
• Cole Rued
• Conner Rued
• Karrie Ruedy
• Janice M Ruelo, MA, CCC-SLP
• Jacquelyn Marie Ruen, DPT, OCS
• Gina L. Ruesch, DPM
• Angelique M Ruff, M.D.
• Paul George Ruff, M.A., L.P.

• Emergency Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.