Individual provider Active NPI

Sara Ruiz

  • Marriage & Family Therapist
  • Madison, WI
National Provider Identifier
1932744067
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
Clock Tower Office Park, 6333 Odana Rd
#20
Madison, WI 53719
Phone
(608) 270-2511
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X WI Primary

Addresses

Primary practice location

Clock Tower Office Park, 6333 Odana Rd
#20
Madison, WI 53719

Mailing address

201 N Brearly St Apt 4
Madison, WI 53703-2354
Phone (920) 471-9743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122000278 MN Practitioner - Marriage and Family Therapist 3476088808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cullain LLC CurrentSince Nov 17, 2019 Accepting new patients
CGC LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

333 Washington Ave N
Minneapolis, MN 55401
Phone (612) 349-2797

4208 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 825-4792

6333 Odana Rd
Ste 20
Madison, WI 53719
Phone (608) 238-6998

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1932744067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N BREARLY ST APT 4",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032354",
            "telephone_number": "920-471-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLOCK TOWER OFFICE PARK, 6333 ODANA RD",
            "address_2": "#20",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "608-270-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.