DR. WILDER SHAWN RUCKER MD
NPI 1235403742
General Practice in Miramar, FL
About Dr. Wilder Shawn Rucker Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WILDER SHAWN RUCKER MD (NPI 1235403742) is an individual general practice provider in Miramar, Florida, licensed in New York (000-26-4414) and active in the NPI registry since March 2012. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Wilder Shawn Rucker Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Wilder Rucker reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Columbia, TN 38401
- Reassigned Medicare billing, Tennessee enrollment
- 64 clinicians in this Medicare group
Brooklyn, NY 11228
- Reassigned Medicare billing, New York enrollment
- 44 clinicians in this Medicare group
Liberty, NY 12754
- Reassigned Medicare billing, New York enrollment
- 32 clinicians in this Medicare group
Cortland, NY 13045
- Reassigned Medicare billing, New York enrollment
- 37 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.
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.
MIRAMAR, FL 33027
MIRAMAR, FL 33027
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 Wilder Rucker's NPI number?
The NPI number for Wilder Rucker is 1235403742. It was assigned to this individual provider in the NPPES registry on March 1, 2012.
Where is Wilder Rucker located?
Wilder Rucker practices at 3601 SW 160th Ave Ste 250, Miramar, FL 33027. The listed phone number is (877) 866-7123.
What is Wilder Rucker's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Wilder Rucker enrolled in Medicare?
Yes. Wilder Rucker is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Wilder Rucker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Wilder Rucker reassigns Medicare benefits to 4 organizations: Cedar Recovery Center Of Middle Tennessee, LLC (Columbia, TN), Renew Medical Of New York, PLLC (Brooklyn, NY), Empire Wound Physician Services, PLLC (Liberty, NY) and Pons Physician Services, PLLC (Cortland, NY). 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 Wilder Rucker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Wilder Rucker accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Wilder Rucker 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.
When was this NPI record last updated?
The NPPES record for Wilder Rucker was last updated on March 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.
# Dr. Wilder Shawn Rucker, MD · NPI 1235403742
General Practice physician in Miramar, Florida. Individual provider, active in the CMS NPPES registry since March 1, 2012.
## Identity
- **NPI:** 1235403742 (Entity type: Individual)
- **Enumerated:** March 1, 2012
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** 000-26-4414 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3601 SW 160TH AVE STE 250, Miramar, FL 33027-6314
- **Phone:** (877) 866-7123
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Cedar Recovery Center Of Middle Tennessee, LLC (NPI 1801345285, Columbia, TN); Renew Medical Of New York, PLLC (NPI 1356979447, Brooklyn, NY); Empire Wound Physician Services, PLLC (NPI 1093130742, Liberty, NY); Pons Physician Services, PLLC (NPI 1457732554, Cortland, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1235403742) · Data from the CMS NPPES public registry.