Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kendra M Ruckman, PA-C

Individual provider Physician Assistant · NPI 1942523600

Kendra M Ruckman, PA-C is a Physician Assistant in Melbourne, Florida. Qualified in 2009, 17 years ago. Practices with Health First Privia Medical Group, a 246-clinician group and accepts Medicare assignment. Licensed in Florida and Georgia.

Years since qualifying
17
Licensed in
FL, GA
In the registry since
2010
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

205 E Nasa Blvd
Melbourne, FL 32901-1950
Phone: (321) 361-5620
Fax: (321) 434-3511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9106918 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 005799 (GA)

Record details

NPI number1942523600
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 10, 2010
Last updated in NPPESMarch 12, 2020
Certification dateMarch 12, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Health First Privia Medical Group — 246 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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