Mariareve Rucinski, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12010 Issued in WI

Practice address

600 N Westhaven Dr
Oshkosh, WI 54904-6926

Phone

(920) 237-5000

Fax

(920) 237-5011

NPI assigned

Apr 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mrucinski330680@direct.thedacare.org

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  NPD
• Water City Care Mission, Inc.

  • Family Nurse Practitioner
  • Oshkosh, WI
  • NPI 1154929909
  NPD

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1124084355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549046926",
            "telephone_number": "920-237-5000",
            "fax_number": "920-237-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549046926",
            "telephone_number": "920-237-5000",
            "fax_number": "920-237-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ben Franklin Village Unit 29920",
            "address_2": "Mannheim Health Clinic",
            "address_purpose": "LOCATION",
            "city": "Apo",
            "state": "AE",
            "postal_code": "09042",
            "country_code": "DE",
            "telephone_number": "496221172274",
            "fax_number": "496221172941",
            "country_name": "Germany",
            "address_type": "FGN"
        },
        {
            "address_1": "333 N Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549561954",
            "country_code": "US",
            "telephone_number": "920-720-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCINSKI",
        "first_name": "MARIAREVE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "612124",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "12010",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "12010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roundys Supermarkets Inc
• Kate M Rouse, PT
• Debanshu Dependra Kumar Roy, M.D.
• Bryan Royce, M.D.
• Kyle Rozek, PTA
• Donald P Ruck, O.D.
• Linda Jo Ruddy, RDH
• James P Rudolph
• Brice Taylor Ruedinger
• Robert Charles Runge Jr., PT

• All providers in Oshkosh, WI
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.