Individual provider Active NPI

Shane Ruckle, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1932133907
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD067927L Issued in PA
Practice address
800 Spruce St
2 Cathcart
Philadelphia, PA 19107-6130
Phone
(215) 829-3264
NPI assigned
Jul 10, 2006
Last updated
May 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 241661 NY
Emergency Medicine Physician 207P00000X V1699 TX
Emergency Medicine Physician 207P00000X 4490 WI
Emergency Medicine Physician 207P00000X MD067927L PA Primary

Addresses

Primary practice location

800 Spruce St
2 Cathcart
Philadelphia, PA 19107-6130

Mailing address

3624 Market St
Suite 560W
Philadelphia, PA 19104-2614
Phone (215) 662-2286

Other practice location 1

1700 W Stout St
Rice Lake, WI 54868-5000
Phone (715) 236-4450

Other identifiers 1

IdentifierTypeStateIssuer
001769535MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI, MI, KY, TX, IL, LA7 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 7

Enrollment IDStateProvider typePAC IDDetails
I20061111000003 NY Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 2 organizations
I20240715001991 WI Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 9 organizations
I20241104001715 MI Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 1 organization
I20241113002591 KY Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 2 organizations
I20250523000811 TX Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 1 organization
I20250924003254 IL Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 1 organization
I20260610003957 LA Practitioner - Emergency Medicine 5698715969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians Emergency Medicine of Texas PLLCGroup PAC ID 9739449802, 112 clinicians
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians
Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

2201 Clear Creek Rd
Killeen, TX 76549-4110
Phone (254) 526-7523

500 Osborn Blvd
Sault S Marie, MI 49783-1822
Phone (906) 635-4460

911 Bypass Rd
BLDG a
Pikeville, KY 41501-1689
Phone (606) 430-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
81.47
Promoting interoperability
100
Improvement activities
40
Cost
81.83

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
241661NYMDEmergency Medicine Physician
V1699TXMDEmergency Medicine Physician
4490WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
MCHS Hospitals Inc Emergency Medicine Current Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jul 1, 2024 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jan 2, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Jul 1, 2024 Accepting new patients
Mymichigan Medical Center Sault Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 1, 2024 Accepting new patients
Upstate Ny Physician PLLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Sound Physicians Emergency Medicine of Texas PLLC Emergency Medicine CurrentSince Mar 8, 2025 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Oct 25, 2024 Accepting new patients
Pikeville Medical Center Inc. CurrentSince Oct 11, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 1, 2024 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Oct 25, 2024 Accepting new patients
Wajeeh Sana Physician PC Emergency Medicine CurrentSince Jun 17, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Jul 1, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jul 1, 2024 Accepting new patients
Iems Physician Services PLLC Emergency Medicine CurrentSince Jul 25, 2025 Accepting new patients
Pikeville Medical Center Inc CurrentSince Oct 11, 2024 Accepting new patients
Owensboro Health Medical Group, Inc. CurrentSince Jan 2, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 1, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jul 1, 2024 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Metro Emergency Medical Association PLLC Emergency Medicine Past Accepting new patients
Emergency Medical Metro P C Emergency Medicine Past Accepting new patients
LH Emergency Medical Services PC Emergency Medicine Past Accepting new patients
Park Lenox Emergency Medicine, PC Emergency Medicine Past Accepting new patients
St. Vincent's Emergency Services PC Emergency Medicine Past Accepting new patients
St Tammany Emergency Physicians Group LLC Emergency Medicine Past Accepting new patients

Locations

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

3600 Gates Blvd
Port Arthur, TX 77642
Phone (409) 985-7431

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 32

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.

View all 32

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1932133907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 MARKET ST",
            "address_2": "SUITE 560W",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042614",
            "telephone_number": "215-662-2286",
            "fax_number": "215-615-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "2 CATHCART",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 W Stout St",
            "address_purpose": "LOCATION",
            "city": "Rice Lake",
            "state": "WI",
            "postal_code": "548685000",
            "country_code": "US",
            "telephone_number": "715-236-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKLE",
        "first_name": "SHANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "241661",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V1699",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "4490",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD067927L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001769535",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1700 W Stout St",
            "city": "Rice Lake",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548685000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.