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PHILLIP RUIZ
NPI 1225042047
Pathology - Anatomic Pathology in Miami, FL

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136(305) 585-6303 Get Directions Write a Review

NPPES record last updated: March 2, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Phillip Ruiz NPPES

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

PHILLIP RUIZ (NPI 1225042047) is an individual anatomic pathology provider in Miami, Florida, licensed in Florida (ME55558) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of George Washington University School Of Medicine (1985).

NPPES Registry Identity

NPI1225042047
Entity TypeIndividualMale
Primary Taxonomy207ZP0101X
Provider Legal NamePHILLIP RUIZ
Location Address1611 NW 12TH AVE, BOX 016960 M851Miami, FL 33136-1005
Mailing Address1611 Nw 12th Ave, Box 016960 M851Miami, FL 33136-1005 · (305) 585-6303
Phone(305) 585-6303
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 1985
Enumeration DateJuly 28, 2006
Last NPPES UpdateMarch 2, 2023
NPPES CertifiedMarch 2, 2023
✔ NPI 1225042047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Anatomic PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0101X
License✔ Licensed in FL · ME55558
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Also ListedPathology · ImmunopathologyTaxonomy 207ZI0100X · License ME55558 (FL)
1611 NW 12TH AVE, Miami, FL 33136
Open in Google Maps ↗

Other Identifiers 1

Medicaid0616044-00FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc..Insurance ›

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

Phillip Ruiz 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.

PECOS PAC ID4183693559
PECOS Enrollment IDI20041001000448
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 Phillip Ruiz reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Miami
Same address
Pulmonary Disease
1611 NW 12TH AVE, BOX 016960 M851
Miami, FL 33136
  • Reassigned Medicare billing, Florida enrollment
  • 3,639 clinicians in this Medicare group
NPI 1003866617 (305) 243-7688
Central Florida Pathology Associates PA
204 mi
Anatomic Pathology & Clinical Pathology
601 E ROLLINS ST, DEPT. OF PATHOLOGY
Orlando, FL 32803
  • Reassigned Medicare billing, Florida enrollment
  • 31 clinicians in this Medicare group
NPI 1255313664 (404) 303-6611
Hospital Espanol Auxilio Mutuo De Puerto Rico, Inc.
Specialist
735 AVE PONCE DE LEON STE 375
San Juan, PR 00917
  • Reassigned Medicare billing, Puerto Rico enrollment
  • 44 clinicians in this Medicare group
NPI 1487947214 (787) 771-7934

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 8

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.

Special stained specimen slides to examine tissue including interpretation and report 88313
Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.
472 services92 patients
Antibody evaluation, each additional single antibody stain procedure 88350
An antibody evaluation involves testing a sample of your body fluid (like blood) to identify specific antibodies. Each additional single antibody stain procedure is a separate test for another specific antibody. This helps in diagnosing various health conditions by understanding your body's immune response.
374 services60 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
229 services99 patients
Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
179 services84 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
129 services99 patients
Antibody evaluation, initial single antibody stain procedure 88346
An antibody evaluation, initial single antibody stain procedure is a laboratory test. It's designed to identify specific proteins, or antibodies, in your body. This can help diagnose certain conditions or monitor your immune system's response to treatments. The procedure involves staining a single type of antibody for detection.
61 services60 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

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.

DR. AKUA GYANEWAH ASARE MD
Student in an Organized Health Care Education/Training Program
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 355-8264
MARILUZ SANCHEZ PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1611 NW 12TH AVE, PHARMACY ADM. OFFICES/EAST TOWER BASEMENT 069
MIAMI, FL 33136
Miami-Dade County (305) 585-7309
DR. TASHA JOYTI N. D. COOKE TASHA COOKE
Student in an Organized Health Care Education/Training Program
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 243-3670
DR. JUANITA ANN MARIE HUNTER M.D.
Pediatrics (Pediatric Cardiology)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-6042
WANDA LAVERNE MCGOWAN-BRAYNEN ARNP
Nurse Practitioner (Adult Health)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-1111
DR. PERTTI KALEVI HAKALA M.D.
Anesthesiology
1611 NW 12TH AVE, CENTRAL 300
MIAMI, FL 33136
Miami-Dade County (305) 585-6970
JAYLOU M VELEZ TORRES M.D.
Pathology (Anatomic Pathology)
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-8381
ANNE-ISABELLE SOPHIA REME MD
Surgery
1611 NW 12TH AVE
MIAMI, FL 33136
Miami-Dade County (305) 585-1280

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 Phillip Ruiz's NPI number?

The NPI number for Phillip Ruiz is 1225042047. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Phillip Ruiz located?

Phillip Ruiz practices at 1611 NW 12th Ave Box 016960 M851, Miami, FL 33136. The listed phone number is (305) 585-6303.

What is Phillip Ruiz's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology, with taxonomy code 207ZP0101X.

Is Phillip Ruiz enrolled in Medicare?

Yes. Phillip Ruiz 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 organizations bill Medicare for Phillip Ruiz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Ruiz reassigns Medicare benefits to 3 organizations: University Of Miami (Miami, FL), Central Florida Pathology Associates PA (Orlando, FL) and Hospital Espanol Auxilio Mutuo De Puerto Rico, Inc. (San Juan, PR). 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 Phillip Ruiz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Phillip Ruiz accept?

Health plans from Cigna HealthCare of Florida, Inc. and Cigna Healthcare list Phillip Ruiz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Phillip Ruiz affiliated with any hospitals?

According to CMS data, Phillip Ruiz is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Phillip Ruiz was last updated on March 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.