Individual provider Active NPI

Kyle Cameron Ruiz, NP

  • Acute Care Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1962108332
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95024153 Issued in CA
Practice address
1477 S Manchester Ave
Anaheim, CA 92802-2905
Phone
(619) 247-5992
NPI assigned
Feb 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95024153 CA Primary

Addresses

Primary practice location

1477 S Manchester Ave
Anaheim, CA 92802-2905

Mailing address

1477 S Manchester Ave
Anaheim, CA 92802-2905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630001478 CA Practitioner - Nurse Practitioner 9638538135 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharwin Tafazoli IncGroup PAC ID 8729416953, 59 clinicians
P H Patel MD IncGroup PAC ID 3274784608, 4 clinicians
Gandhi and Gandhi Medical CorporationGroup PAC ID 5597811687, 3 clinicians

Practice addresses (Care Compare)

1819 Washington Ave
Apt a
Santa Monica, CA 90403-3324
Phone (310) 382-0233

2400 E 4TH St
National City, CA 91950-2026
Phone (619) 472-4690

555 Washington St
San Diego, CA 92103-2289
Phone (858) 531-7713

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024153CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gandhi & Gandhi Medical Corporation CurrentSince Jun 11, 2024 Accepting new patients
Pouya Afshar MD Inc CurrentSince Jun 28, 2023 Accepting new patients
Ellyn Levine, MD, Inc. Current Accepting new patients
P H Patel MD Inc CurrentSince Jun 1, 2023 Accepting new patients
Samir B Damani MD Inc CurrentSince May 1, 2025 Accepting new patients
SD Premier Cardiac Center Inc PastSince Aug 27, 2023 Accepting new patients
Samir B. Damani MD Inc Past Accepting new patients

Locations

9850 Genesee Ave
Ste 650
La Jolla, CA 92037
Phone (858) 223-2100

2400 E 4th St
National City, CA 91950
Phone (619) 470-4141

655 Euclid Ave
Ste 401
National City, CA 91950
Phone (619) 267-8303

655 Euclid Ave
Ste 301
National City, CA 91950
Phone (619) 267-3020

555 Washington St
San Diego, CA 92103
Phone (619) 260-8300

3111 Camino del Rio N
Ste 625
San Diego, CA 92108
Phone (619) 738-5566

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 2

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": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1962108332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 S MANCHESTER AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928022905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 S MANCHESTER AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928022905",
            "telephone_number": "619-247-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "KYLE",
        "middle_name": "CAMERON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95024153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.