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SHANNA RUCKER NP
NPI 1194307421
Nurse Practitioner - Family in Los Angeles, CA

Active since April 26, 2021PECOS Enrolled
2707 S CENTRAL AVE, LOS ANGELES, CA 90011(702) 612-6316 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shanna Rucker Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNA RUCKER NP (NPI 1194307421) is an individual family provider in Los Angeles, California, licensed in California (95017042) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1194307421
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNA RUCKERCredential: NP
Location Address2707 S CENTRAL AVELos Angeles, CA 90011-5527
Mailing Address8416 Delco AveWinnetka, CA 91306-1317 · (702) 612-6316
Phone(702) 612-6316
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateApril 26, 2021
NPPES CertifiedApril 26, 2021
✔ NPI 1194307421 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95017042
2707 S CENTRAL AVE, Los Angeles, CA 90011
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shanna Rucker Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890167159
PECOS Enrollment IDI20230214002561
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Shanna Rucker reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Amniotti Inc
7.5 mi
Multi-Specialty
113 N SAN VICENTE BLVD STE 368
Beverly Hills, CA 90211
  • Reassigned Medicare billing, California enrollment
  • 4 clinicians in this Medicare group
NPI 1780465062 (866) 316-9062
Feldmar Medical Corporation
8.7 mi
Plastic Surgery
9301 WILSHIRE BLVD STE 100
Beverly Hills, CA 90210
  • Reassigned Medicare billing, California enrollment
  • 8 clinicians in this Medicare group
NPI 1669773859 (310) 820-2111
Woundologie Nursing PC
44 mi
Family
7262 SUNNYSLOPE DR
Lancaster, CA 93536
  • Reassigned Medicare billing, California enrollment
NPI 1700755063 (702) 612-6316

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 10

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.

Restorigin, per square centimeter Q4191
Restorigin is a medical procedure that helps in the regeneration of skin tissue. It's typically used for wound healing and involves the application of skin cells to the affected area. The service is charged per square centimeter, relating to the size of the treatment area.
1,220 services11 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
666 services81 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
455 services68 patients
Removal of skin and tissue, each additional 20.0 sq cm or less 11045
This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.
335 services23 patients
Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less 15271
This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.
279 services35 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
145 services38 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

CENTRAL NEIGHBORHOOD MEDICAL GROUP, INC.
Clinic/Center (Primary Care)
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (323) 234-5000
CALIFORNIA INSTITUE OF HEALTH & SOCIAL SERVICES, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (310) 645-5227
DR. KAREN SIMONA RODRIGUES MD
Student in an Organized Health Care Education/Training Program
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (323) 234-5000
MEHRANGIZ CADRY MD
Family Medicine (Hospice and Palliative Medicine)
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (310) 422-5001
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Clinic/Center (Primary Care)
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (323) 234-5000
KAMALA KENNETRIA GIPSON PNP
Nurse Practitioner (Pediatrics)
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (323) 234-5000
RONALD HARMON MD
Family Medicine
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (323) 234-5000
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Clinic/Center (Federally Qualified Health Center (FQHC))
2707 S CENTRAL AVE
LOS ANGELES, CA 90011
Los Angeles County (323) 234-5000

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 Shanna Rucker's NPI number?

The NPI number for Shanna Rucker is 1194307421. It was assigned to this individual provider in the NPPES registry on April 26, 2021.

Where is Shanna Rucker located?

Shanna Rucker practices at 2707 S Central Ave, Los Angeles, CA 90011. The listed phone number is (702) 612-6316.

What is Shanna Rucker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shanna Rucker enrolled in Medicare?

Yes. Shanna Rucker is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shanna Rucker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shanna Rucker reassigns Medicare benefits to 3 organizations: Amniotti Inc (Beverly Hills, CA), Feldmar Medical Corporation (Beverly Hills, CA) and Woundologie Nursing PC (Lancaster, CA). Each 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 Shanna 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 Shanna Rucker was last updated on April 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.