Individual provider Active NPI

Ronald S. Jurzyk, MD

  • Dermatology Physician
  • Wolcott, CT
National Provider Identifier
1215910922
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
035267 Issued in CT
Practice address
464 Wolcott Rd Ste 3
Wolcott, CT 06716-2626
Phone
(203) 879-6171
Fax
(203) 879-1191
NPI assigned
Nov 28, 2005
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 035267 CT Primary
Dermatopathology Physician 207ND0900X 035267 CT

Addresses

Primary practice location

464 Wolcott Rd Ste 3
Wolcott, CT 06716-2626

Mailing address

464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040305000025 CT Practitioner - Dermatology 2466340286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Hahnemann University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology Center, PCGroup PAC ID 5294623005, 4 clinicians

Practice addresses (Care Compare)

464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions364
Skin biopsy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035267CTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Waterbury, LLC Dermatology CurrentSince Mar 1, 2026 Accepting new patients
Advanced Dermatology Center, PC Dermatology CurrentSince Jan 1, 2003 Accepting new patients
Integrated Dermatology of Wolcott PLLC Dermatology PastSince Mar 1, 2026 Accepting new patients

Locations

464 Wolcott Rd
Wolcott, CT 06716
Phone (203) 633-4560

464 Wolcott Rd
Ste 3
Wolcott, CT 06716
Phone (203) 879-6171

4700 Exchange Ct
Ste 110
Boca Raton, FL 33431
Phone (561) 223-8081

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1215910922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162626",
            "telephone_number": "203-879-6171",
            "fax_number": "203-879-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 WOLCOTT RD STE 3",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162626",
            "telephone_number": "203-879-6171",
            "fax_number": "203-879-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURZYK",
        "first_name": "RONALD",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "035267",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CT",
            "license": "035267",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolcott, CT

Sources for this page

Verify at the official NPI Registry.