Mack T Ruffin IV, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD459216 Issued in PA

Practice address

140 Old Willow Mill Rd
Mechanicsburg, PA 17050-1816

Phone

(717) 766-4635

Fax

(717) 766-4818

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

56.69

Promoting interoperability

100

Improvement activities

40

Cost

74.52

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Joseph Regional Health Network

  • Family Medicine Physician
  • Reading, PA
  • NPI 1396786414
  Medicare reassignment NPD
• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744
  Medicare reassignment NPD
• Berks Pathology Associates, Inc

  • Clinical Pathology/Laboratory Medicine Physician
  • Reading, PA
  • NPI 1700052677
  NPD
• St Joseph Regional Health Network

  • Urgent Care Clinic/Center
  • Temple, PA
  • NPI 1255790739
  NPD
• The Milton S Hershey Medical Center Physician Group

  • Body Imaging Physician
  • Hershey, PA
  • NPI 1346215928
  NPD
• The Milton S Hershey Medical Center Physicians Group

  • Family Medicine Physician
  • Hershey, PA
  • NPI 1538134234
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1245329101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 OLD WILLOW MILL RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170501816",
            "telephone_number": "717-766-4635",
            "fax_number": "717-766-4818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 N 6th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196013096",
            "country_code": "US",
            "telephone_number": "610-208-4558",
            "fax_number": "610-378-2441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "MACK",
        "middle_name": "T",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301055570",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD459216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "534246",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031816190001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2623517",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy E Monsour MD Professional Corporation
• Christopher D Royer, PSYD
• Lauren Elisabeth Royer, LPC-ASSOCIATE
• Morton Jerome Rubenstein, MD
• Morton Louis Rubin, M.D.
• Danielle Rummel, LSW
• Kathleen Nicole Rupp, MD
• Kierra Russler
• Heather Rose Russo-Sikes, DO
• Daniel J Russo, ED.D.

• Family Medicine Physician in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.