ANDREW CONRAD RUCKER
NPI 1083150015
Nurse Practitioner - Family in Kingman, AZ
About Andrew Conrad Rucker NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW CONRAD RUCKER (NPI 1083150015) is an individual family provider in Kingman, Arizona, licensed in Arizona (AP9899) and active in the NPI registry since January 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Andrew Conrad Rucker is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Andrew Rucker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Trinidad, CO 81082
- Reassigned Medicare billing, Arizona enrollment
- 71 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 86409 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KINGMAN, AZ 86409
KINGMAN, AZ 86409
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Rucker's NPI number?
The NPI number for Andrew Rucker is 1083150015. It was assigned to this individual provider in the NPPES registry on January 14, 2017.
Where is Andrew Rucker located?
Andrew Rucker practices at 3269 N Stockton Hill Rd, Kingman, AZ 86409. The listed phone number is (928) 757-2101.
What is Andrew Rucker's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Andrew Rucker enrolled in Medicare?
Yes. Andrew Rucker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Andrew Rucker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Rucker reassigns Medicare benefits to Innova Emergency Medical Associates PC (Trinidad, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Rucker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Andrew Rucker was last updated on February 8, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Andrew Conrad Rucker · NPI 1083150015
Family physician in Kingman, Arizona. Individual provider, active in the CMS NPPES registry since January 14, 2017.
## Identity
- **NPI:** 1083150015 (Entity type: Individual)
- **Enumerated:** January 14, 2017
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** AP9899 (Arizona)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3269 N STOCKTON HILL RD, Kingman, AZ 86409-3619
- **Phone:** (928) 757-2101
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Innova Emergency Medical Associates PC (NPI 1295178978, Trinidad, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** February 8, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1083150015) · Data from the CMS NPPES public registry.