DR. WILDER SHAWN RUCKER MD
NPI 1235403742
General Practice in Miramar, FL

Q: 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.

Q: What is Wilder Rucker's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: 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 4 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.

Active since March 01, 2012PECOS Enrolled

3601 SW 160TH AVE STE 250, MIRAMAR, FL 33027(877) 866-7123 Get Directions Write a Review

NPPES record last updated: March 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 13, 2026, Aug 17, 2016 (2 updates tracked since 2016).

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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

NPI1235403742

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. WILDER SHAWN RUCKERCredential: MD

Location Address3601 SW 160TH AVE STE 250Miramar, FL 33027-6314

Mailing Address1276 Dekalb Ave # 4aBrooklyn, NY 11221-3204 · (718) 490-0738

Phone(877) 866-7123

Sole ProprietorYes

Enumeration DateMarch 1, 2012

Last NPPES UpdateMarch 13, 20262 updates tracked since enumeration

NPPES CertifiedMarch 13, 2026

✔ NPI 1235403742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in NY · 000-26-4414

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedFamily MedicineTaxonomy 207Q00000X · License 264414 (NY)

Also ListedSurgeryTaxonomy 208600000X · License 264414 (NY)

3601 SW 160TH AVE STE 250, Miramar, FL 33027

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida, Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Wilder Shawn Rucker Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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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.

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