Individual provider Active NPI

Francis X Ruzicka, MD

  • Family Medicine Physician
  • West Allis, WI
National Provider Identifier
1104886902
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33557 Issued in WI
Practice address
801 S 70TH St
West Allis, WI 53214-3147
Phone
(414) 773-6600
Fax
(414) 773-6672
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33557 WI Primary

Addresses

Primary practice location

801 S 70TH St
West Allis, WI 53214-3147

Mailing address

4425 N Port Washington Rd
Attn: Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 773-6600

Other identifiers 1

IdentifierTypeStateIssuer
31988300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100123000061 WI Practitioner - Family Practice 3577605989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33557WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Aug 14, 1994 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine CurrentSince Aug 14, 1994 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Past Accepting new patients

Locations

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1104886902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-773-6600",
            "fax_number": "414-773-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S 70TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143147",
            "telephone_number": "414-773-6600",
            "fax_number": "414-773-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZICKA",
        "first_name": "FRANCIS",
        "middle_name": "X",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "33557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31988300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.