NPIMap

Individual provider Active NPI

Elizabeth A. Ruckdeschel, M.D./PH.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
National Provider Identifier
1275767774
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
261284 Issued in NY
Practice address
750 E. Adams Street
Department of Pathology
Syracuse, NY 13210-2306
Phone
(315) 464-6751
Fax
(315) 464-6749
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 261284 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 261284-1 NY

Addresses

Primary practice location

750 E. Adams Street
Department of Pathology
Syracuse, NY 13210-2306

Mailing address

224 Harrison Street
Ste 600
Syracuse, NY 13202
Phone (315) 464-6751

Other names 1

  • Miss Elizabeth A. Patchett Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141205000246 NY Practitioner - PathologyPractitioner - Hematology 4082936851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
State University of New York at Buffalo School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Pathologists Laboratories, LLPGroup PAC ID 8325038276, 25 clinicians

Practice addresses (Care Compare)

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.3 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261284-1NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmology Medical Service Group Inc Current Accepting new patients

Locations

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1275767774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HARRISON STREET",
            "address_2": "STE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13202",
            "telephone_number": "315-464-6751",
            "fax_number": "315-464-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E. ADAMS STREET",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-6751",
            "fax_number": "315-464-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKDESCHEL",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D./PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "261284",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "261284-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PATCHETT",
            "middle_name": "A.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.