NPIMap

Individual provider Active NPI

Theodore Wenner Ruzanic, MD

  • Emergency Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1932273943
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49227 Issued in MN
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone
(612) 672-6000
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49227 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1450

Mailing address

4322 Pleasant Ave
Minneapolis, MN 55409-1922

Other names 1

  • Theodore Roe Ruzanic Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address truzanic1738@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070112000338 MN Practitioner - Emergency Medicine 6002816113 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians
Centracare Health System - Sauk CentreGroup PAC ID 4981857216, shared by 3 NPIs, 24 clinicians

Practice addresses (Care Compare)

110 2ND St S
Suite 104
Waite Park, MN 56387-1367
Phone (320) 259-9375

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

2035 15TH St N
Saint Cloud, MN 56303-1738
Phone (320) 656-7100

425 Elm St N
Sauk Centre, MN 56378-1010
Phone (320) 352-2221

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Centracare Health System - Sauk Centre Hospital, Sauk Centre, MN, CCN 241368

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue111
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health Systems Current Accepting new patients
Group Health, Inc. Current Accepting new patients
St Cloud Pathologists PA Current Accepting new patients
Regional Diagnostic Radiology Current Accepting new patients
Group Health, Inc. CurrentSince Feb 24, 2016 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Mar 1, 2017 Accepting new patients
Centracare Health System-NR LLC CurrentSince Feb 1, 2015 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Aug 1, 2015 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Aug 1, 2015 Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Clinic CurrentSince May 1, 2018 Accepting new patients
Group Health Plan, Inc. CurrentSince Feb 24, 2016 Accepting new patients
St. Cloud Hospital CurrentSince Oct 1, 2010 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

2035 15th St N
Ste 130
Saint Cloud, MN 56303
Phone (320) 656-7100

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Interoperability endpoints

  • Direct secure messaging: truzanic1738@direct.centracare.com

Organizations & group practices 16

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.

View all 16

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1932273943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4322 PLEASANT AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-672-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZANIC",
        "first_name": "THEODORE",
        "middle_name": "WENNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "49227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "truzanic1738@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "truzanic1738@direct.centracare.com",
            "address_1": "2035 15th St N Ste 130",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563031765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THEODORE",
            "last_name": "RUZANIC",
            "middle_name": "ROE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.