Mark C Ruchman, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

022088 Issued in CT

Practice address

1 Reservoir Office Park Ste 203
1449 Old Waterbury Rd
Southbury, CT 06488-3926

Phone

(203) 264-4000

Fax

(203) 264-4002

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mark.ruchman.p1@direct.danburyeye.nextgenshare.com
• Direct secure messaging: mruchman@direct.wtbyhosp.org

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1497717680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RESERVOIR OFFICE PARK STE 203",
            "address_2": "1449 OLD WATERBURY RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883926",
            "telephone_number": "203-264-4000",
            "fax_number": "203-264-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RESERVOIR OFFICE PARK STE 203",
            "address_2": "1449 OLD WATERBURY RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883926",
            "telephone_number": "203-264-4000",
            "fax_number": "203-264-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCHMAN",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "022088",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CT",
            "license": "022088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001220888",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlynn Rossomando
• Philip Rothfeld, MD
• Liza Roxas
• RSS Medical Consulting, LLC
• Andrew L Rubman, N.D.
• Yvonne Ann Ruddy-Stein, APRN
• Jennifer Ruiz, DPT
• Darrell Ruopp, OT, ATP
• Gina Rupert, PAC
• Brandi Elise Sabato

• Ophthalmic Plastic and Reconstructive Surgery Physician in Southbury, CT
• Providers in Southbury, CT by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.

Verify at the official NPI Registry.