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Dr. Brandon Michael Rucker , MD

Pediatrics β€’ Summit, WI

Active NPI 1477843001 Individual Practitioner Male Practitioner
Practice location in NPPES

36500 Aurora Dr
Summit, WI 530664899

Call 2624345000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

36500 Aurora Dr

Summit, WI 530664899

Telephone 2624345000
Organization at the Same NPPES Address or Phone
Aurora Health Care Ventures Inc. Facility NPI 1376791020

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Green Bay, WI. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Rucker has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Rucker as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Summit and Wisconsin

3 active clinicians are listed under Pediatrics with a practice address in Summit, WI (1,203 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-10-03
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES WI 62013-20

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
100038333 (WI)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20140604001687

Enrollment State Jurisdiction

WI

PECOS Control ID

8022232420

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

1160 Kepler Dr

Green Bay, WI 543118321

Phone: 9202888450

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

40 listed
NPI 1952339699

RNC, Master of Science in Nursing

Dr. Inna Allen , MD

Family Medicine

NPI 1649581315

Doctor of Medicine (M.D.)

NPI 1992816748

Doctor of Medicine (M.D.)

Marie Bruce , APNP

Nurse Practitioner

NPI 1760635692

Advanced Practice Nurse Prescriber

Elizabeth Daniels , PA

Physician Assistant - Surgical

NPI 1285279844

Physician Assistant

Dr. Meridith Derrig , MD

Obstetrics & Gynecology

NPI 1780601633

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location October 03, 2023

Registered at 36500 AURORA DR, SUMMIT, WI 530664899 (Tel: 2624345000)

πŸ“
Updated Business Mailing Address October 03, 2023

Registered at PO BOX 735044, CHICAGO, IL 606735044 (Tel: 2624345000)

βœ…
NPI Profile Active July 03, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 03, 2014

Registered at 1160 KEPLER DR, GREEN BAY, WI 543118321 (Tel: 9202888450)

πŸ“
Business Mailing Address (Initial Record) July 03, 2014

Registered at 1160 KEPLER DR, GREEN BAY, WI 543118321 (Tel: 9202888450)

πŸ‘€
Provider Name / Credentials (Initial Record) July 03, 2014

Recorded as BRANDON RUCKER, M.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 03, 2014

Pediatrics (license number reported to NPPES: WI 62013-20)

🟒
Initial NPI Registration & Enumeration April 16, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1477843001
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 16, 2011
Last Update: October 03, 2023
Sole Proprietor: No

Mailing Address

Po Box 735044

Chicago, IL 606735044

Phone: 2624345000

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.