Individual provider Active NPI

Sun Young Ruggeri, MD

  • Dermatology Physician
  • Brookfield, WI
National Provider Identifier
1427121979
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
47562-202 Issued in WI
Practice address
13800 W North Ave
Ste 100
Brookfield, WI 53005-4974
Phone
(262) 754-4488
Fax
(262) 754-4940
NPI assigned
Nov 15, 2006
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 47562-202 WI Primary

Addresses

Primary practice location

13800 W North Ave
Ste 100
Brookfield, WI 53005-4974

Mailing address

13800 W North Ave
Ste 100
Brookfield, WI 53005-4974
Phone (262) 754-4488

Other practice location 1

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321
Phone (414) 454-8000

Other identifiers 3

IdentifierTypeStateIssuer
P00430684OtherWIRAILROAD MEDICARE
34925900MedicaidWI
475622000002OtherWIBLUE CROSS BLUE SHEILD

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
I20070702000068 WI Practitioner - Dermatology 0244339307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Baylor College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians
Affiliated Dermatologists SCGroup PAC ID 8123065794, 12 clinicians

Practice addresses (Care Compare)

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321
Phone (414) 454-8000

13800 W N Ave
Suite 100
Brookfield, WI 53005-4977
Phone 2627544488119

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as group
Quality
90.63
Improvement activities
40
Cost
82.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions985
Removal or shaving of skin growth1-10
Skin biopsy218

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47562-202WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Dermatologists, SC Dermatology CurrentSince Jul 1, 2007 Accepting new patients
Affiliated Dermatologists SC Dermatology CurrentSince Jul 1, 2007 Accepting new patients
The Medical College of Wisconsin, Inc. Dermatology CurrentSince Jun 28, 2007 Accepting new patients
Affiliated Dermatologists SC Dermatology PastSince Jun 22, 2021 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

13800 W North Ave
Ste 100
Brookfield, WI 53005
Phone (262) 754-4488

14555 W National Ave
Ste 190
New Berlin, WI 53151
Phone (262) 754-4488

1111 Delafield St
Ste 308
Waukesha, WI 53188
Phone (262) 542-4251

10000 W Bluemound Rd
Wauwatosa, WI 53226
Phone (414) 456-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: yruggerimd7558@direct.froedtert.com

Organizations & group practices 5

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 2

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1427121979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE",
            "address_2": "STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054974",
            "telephone_number": "262-754-4488",
            "fax_number": "262-754-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE",
            "address_2": "STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054974",
            "telephone_number": "262-754-4488",
            "fax_number": "262-754-4940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 W Bluemound Rd",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532264321",
            "country_code": "US",
            "telephone_number": "414-454-8000",
            "fax_number": "414-805-3808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGGERI",
        "first_name": "SUN YOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "47562-202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00430684",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34925900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "475622000002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.