Timothy Joseph Rusiecki, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17871 Issued in MA

Practice address

1176 Memorial Drive
Chicopee, MA 01020-3960

Phone

(413) 593-5772

Fax

(413) 593-5199

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508959016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 MEMORIAL DRIVE",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010203960",
            "telephone_number": "413-593-5772",
            "fax_number": "413-593-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 MEMORIAL DRIVE",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010203960",
            "telephone_number": "413-593-5772",
            "fax_number": "413-593-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSIECKI",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Rossi
• Alexus Rovelli
• Allison Rowan
• Catherine Roxo, RPH
• Elly Rozell
• Julia Ryan
• Muhammad Ali Saeed, BDS, AEGD RESIDENT
• Kage Jonus Sagan, LMHC GRAD STUDENT
• Amanda Noelle Sakowicz
• Irini Salama, PHARMD

• General Practice Dentistry in Chicopee, MA
• Providers in Chicopee, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.