MR. ELIAS OMAR RUILOBA (MD) – Psychiatry Physician, NPI 1124014196
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
563 PSYCHIATRY in AZ
Provider Addresses for MR. ELIAS OMAR RUILOBA (MD)
36457 N Gantzel Rd Ste 102
San Tan Valley, AZ 851407343
Phone: (480) 626-7584
Type: Location
2046 W Riverview Auto Dr Ste 401
Mesa, AZ 852017597
Phone: (480) 626-7584
Type: Location
2002 N Stockton Hill Rd
#104
Kingman, AZ 864014698
Phone: (928) 718-4800
Fax: (928) 757-3256
Type: Location
1501 N Gilbert Rd Ste 206
Gilbert, AZ 852342394
Phone: (480) 626-7584
Type: Location
2355 E Camelback Rd Ste 625
Phoenix, AZ 850163458
Phone: (480) 626-7584
Type: Location
4545 E Chandler Blvd Ste 308
Phoenix, AZ 850487646
Phone: (480) 626-7584
Type: Location
1860 N 95th Ln Ste 300
Phoenix, AZ 850375074
Phone: (480) 626-7584
Type: Location
20950 N TATUM BLVD STE 380
PHOENIX, AZ 850504258
Phone: (480) 626-7584
Fax: (480) 210-0230
Type: Mailing
Stockton Hill Road, Kingman, Mohave County, Arizona, 86409, United States
#104
KINGMAN, AZ 864014698
Phone: (928) 718-4800
Fax: (928) 757-3256
Type: Location
Sycamore Avenue, Kingman, Mohave County, Arizona, 86409, United States
KINGMAN, AZ 864090927
Phone: (928) 757-8111
Fax: (928) 757-3256
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 284 Open Payments records for all available years, with a total value of $6,079.
Total Amount is formed as General ($6,079) + Research ($0) + Ownership ($0) = $6,079.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($1,352).
Total Amount
$6,079
General + Research + Ownership
Payments
284
Total payment records
General Amount
$6,079
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,352 |
| Alkermes, Inc. | $798 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $353 |
| Axsome Therapeutics, Inc. | $351 |
| ITI, Inc. | $329 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-08-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040803000023 | I | Psychiatry | AZ | TBD |
| I20110822000365 | I | Psychiatry | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 49 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 47 | 19 | $0 |
Insurance plans in this area (ZIP 85140)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| Nurse Practitioner | AZ | |
| - | AZ | |
| Nurse Practitioner | KY | |
| - | VA | |
| Nurse Practitioner | AZ | |
| Neurology, Psychiatry | FL | |
| Nurse Practitioner | AZ | |
| - | AZ | |
| Mental Health Counselor | AZ |
Reviews
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