Individual provider Active NPI

Rafael Miguel Ruggieri, M.D.

  • Surgery Physician
  • Champaign, IL
National Provider Identifier
1932335130
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036141048 Issued in IL
Practice address
3101 Fields South Dr
Champaign, IL 61822-3743
Phone
(217) 366-1228
Fax
(217) 366-6106
NPI assigned
Jun 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036141048 IL Primary

Addresses

Primary practice location

3101 Fields South Dr
Champaign, IL 61822-3743

Mailing address

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1228

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rruggierimd216896@CarleHieDirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160826001978 IL Practitioner - General Surgery 1658594999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1200

108 Robinson St
Danville, IL 61832-8515
Phone (217) 442-8611

109 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-5180

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

1710 E Windsor Rd
Urbana, IL 61802-9564
Phone (217) 344-9440

300 N Main St
Tuscola, IL 61953-1406
Phone (217) 253-9258

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
  • Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093
  • Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)11
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions15
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036141048ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC CurrentSince Aug 1, 2016 Accepting new patients
Carle Health Care Incorporated CurrentSince Apr 29, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Mary Rutan Hospital Past Accepting new patients

Locations

101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255

3101 Fields South Dr
Champaign, IL 61822
Phone (217) 366-1237

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: rruggierimd255163@carlehiedirect.net
  • Direct secure messaging: rruggierimd216896@carlehiedirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1932335130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1228",
            "fax_number": "217-366-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223743",
            "telephone_number": "217-366-1228",
            "fax_number": "217-366-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERI",
        "first_name": "RAFAEL",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036141048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rruggierimd216896@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3101 Fields South Dr",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618223743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.