Active NPI
Adam J Ruskowski
- Pediatrics Physician
- Pembroke Pines, FL
National Provider Identifier
1487974747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OS9823
- Practice address
- 400 N Hiatus Rd Ste 105
Pembroke Pines, FL 33026-5214 - Phone
- (954) 431-8000
- NPI assigned
- Jun 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | UO2435 | FL | |
| Pediatrics Physician | 208000000X | OS9823 | FL | Primary |
Addresses
Primary practice location
400 N Hiatus Rd Ste 105
Pembroke Pines, FL 33026-5214
Mailing address
3763 Millenia Blvd Apt 303
Orlando, FL 32839-6469
Phone (740) 590-6572
Other practice location 1
5900 S John Young Pkwy
Orlando, FL 32839-3716
Phone (407) 398-6470 ext. 209
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009464400 | Medicaid | FL | |
| OS12322 | Other | FL | OS12322 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130326000349 | FL | Order and Referring Only - Pediatric Medicine | 3577708411 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS9823 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson | Pediatrics | Past | Accepting new patients |
| Saltzman, Tanis, Pittell, Levin and Jacobson, LLC | Pediatrics | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
Pediatrics
-
- Pediatrics Physician
- Pembroke Pines, FL
- NPI 1881802544
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1487974747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3763 MILLENIA BLVD APT 303",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328396469",
"telephone_number": "740-590-6572",
"fax_number": "740-590-6572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N HIATUS RD STE 105",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330265214",
"telephone_number": "954-431-8000"
}
],
"practiceLocations": [
{
"address_1": "5900 S John Young Pkwy",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328393716",
"country_code": "US",
"telephone_number": "407-398-6470 x209",
"fax_number": "407-894-6872",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSKOWSKI",
"first_name": "ADAM",
"middle_name": "J",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-09",
"last_updated": "2024-06-10",
"certification_date": "2024-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "UO2435",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "OS9823",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009464400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OS12322",
"identifier": "OS12322",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.