Gustave Theodore Ruckert V, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

283516 Issued in NY

Practice address

21 Willow Pond Way Ste 100
Penfield, NY 14526-2687

Phone

(585) 641-0399

Fax

(585) 641-0388

NPI assigned

Apr 20, 2012

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 NY

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

Specialty

Obstetrics/Gynecology

Education

Albany Medical College of Union University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesee Valley Obstetrics and Gynecology PCGroup PAC ID 1951326719, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Genesee Valley Obstetrics & Gynecology, P.C.

  • Obstetrics Physician
  • Penfield, NY
  • NPI 1730229048
  Medicare reassignment Care Compare group NPD
• St James Hospital

  • Rural Acute Care Hospital
  • Hornell, NY
  • NPI 1013985399
  Medicare reassignment NPD
• Highland Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1972548568
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Rochester

  dba Strong Memorial Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1346285657
  Care Compare affiliation
• University of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1669126090
  Care Compare affiliation

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1558628180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY",
            "address_2": "STE 100",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-697-3201",
            "fax_number": "585-641-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY STE 100",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-641-0399",
            "fax_number": "585-641-0388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 N Main St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "NY",
            "postal_code": "145691015",
            "country_code": "US",
            "telephone_number": "585-786-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "990 South Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202740",
            "country_code": "US",
            "telephone_number": "585-232-3210",
            "fax_number": "585-641-0388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKERT",
        "first_name": "GUSTAVE",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "name_suffix": "V",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "283516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Rivera, LMHC
• Courtney Robertson
• Nitza Ivette Rodriguez, LMFT
• Alanna Roemer-Koke, LCSW-R
• Renee Lynn Roland, DDS
• Leah Marie Ruiz, P.A.
• Elizabeth Bruce Russell
• Elaine Rzadca, RPH
• Judy Lynne Gambino Sallmen, OTR/L
• Bonnie Lynne Samuels, RN

• Obstetrics & Gynecology Physician in Penfield, NY
• Providers in Penfield, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.