NPIMap

Individual provider Active NPI

Ronald J Prucha Jr., MD

  • Family Medicine Physician
  • Fuquay Varina, NC
National Provider Identifier
1982674362
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013-00484 Issued in NC
Practice address
231 N Judd Pkwy NE
Fuquay Varina, NC 27526
Phone
(919) 235-6410
Fax
(919) 235-6411
NPI assigned
Jan 26, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2013-00484 NC Primary

Addresses

Primary practice location

231 N Judd Pkwy NE
Fuquay Varina, NC 27526

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490

Other identifiers 1

IdentifierTypeStateIssuer
010160219MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rprucha231510@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130507000703 NC Practitioner - Family Practice 6406891910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694
Phone (919) 235-6410

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2644GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Jul 23, 2018 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wake Specialty Physicians, LLC Family Medicine CurrentSince Jul 23, 2018 Accepting new patients
Wake Specialty Physicians, LLC Family Medicine Current Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients

Locations

110 Kildaire Park Dr
Cary, NC 27518
Phone (919) 235-0616

215 Brightmore Dr
Cary, NC 27518
Phone (919) 235-6575

222 Ashville Ave
Cary, NC 27518
Phone (919) 576-2330

231 N Judd Pkwy NE
Fuquay Varina, NC 27526
Phone (919) 235-6410

101 Cotten Ln
Holly Springs, NC 27540
Phone (919) 235-6456

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

2920 Highwoods Blvd
Raleigh, NC 27604

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: rprucha231510@directhisp.wakemed.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1982674362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N JUDD PKWY NE",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "27526",
            "telephone_number": "919-235-6410",
            "fax_number": "919-235-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUCHA",
        "first_name": "RONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-00484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010160219",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rprucha231510@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "231 N Judd Pkwy NE",
            "city": "Fuquay Varina",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.