Individual provider Active NPI

Shavkat R Ruziev, MD

  • Internal Medicine Physician
  • Lebanon, PA
National Provider Identifier
1578724308
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD445750 Issued in PA
Practice address
974 Isabel Dr
Lebanon, PA 17042-7482
Phone
(717) 297-7900
Fax
(717) 273-7323
NPI assigned
Jun 24, 2008
Last updated
Oct 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD445750 PA Primary
Internal Medicine Physician 207R00000X 204756 LA

Addresses

Primary practice location

974 Isabel Dr
Lebanon, PA 17042-7482

Mailing address

974 Isabel Dr
Lebanon, PA 17042-7482
Phone (717) 297-7900

Other practice location 1

4000 Linglestown Rd
Harrisburg, PA 17112-1017
Phone (717) 231-8867

Other practice location 2

245 Bloomfield Dr Ste 210
Lititz, PA 17543-7788
Phone (717) 297-7900

Other identifiers 2

IdentifierTypeStateIssuer
1160652MedicaidLA
102757120MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120911000216 PA Practitioner - Internal MedicinePractitioner - Hospitalist 1850560483 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Geriatric's, Inc.Group PAC ID 4486551371, 102 clinicians
Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians

Practice addresses (Care Compare)

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221

974 Isabel Dr
Lebanon, PA 17042-7482
Phone (717) 297-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Regional Physicians Internal Medicine CurrentSince Aug 26, 2017 Accepting new patients
Pinnacle Health Hospitalist Services LLC Internal Medicine CurrentSince Apr 1, 2015 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Lebanon Wellness Internal Medicine CurrentSince Nov 30, 2022 Accepting new patients
Suburban Geriatrics II PC Internal Medicine CurrentSince Aug 2, 2025 Accepting new patients
Pinnacle Health Regional Physicians CurrentSince Aug 26, 2017 Accepting new patients
Pinnacle Health Medical Services CurrentSince Dec 9, 2018 Accepting new patients
Qualicare Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Dec 9, 2018 Accepting new patients
Violet Valley Long Term Care PC CurrentSince Aug 18, 2025 Accepting new patients
Suburban Geriatrics, Inc. Internal Medicine CurrentSince Aug 2, 2025 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Aug 1, 2016 Accepting new patients
J C Blair Medical Services Inc Internal Medicine CurrentSince Jun 1, 2015 Accepting new patients
Pinnacle Health Medical Services Internal Medicine Current Accepting new patients
Lebanon Wellness Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Parish Hospital Service District for the Parish of Orleans Dist a Past Accepting new patients
East Jefferson Physicians Group LLC Internal Medicine Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

366 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-1900

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1404 Baltimore St
Ste 4
Hanover, PA 17331
Phone (717) 637-0470

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206

7651 Lake Raystown Shopping Ctr
Huntingdon, PA 16652
Phone (814) 643-8485

974 Isabel Dr
Lebanon, PA 17042
Phone (717) 277-0612

4000 Linglestown Rd
Linglestown, PA 17112
Phone (717) 231-8867

245 Bloomfield Dr
Ste 210
Lititz, PA 17543
Phone (717) 297-7900

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

2901 Jolly Rd
Plymouth Mtng, PA 19462
Phone (610) 272-3222

Interoperability endpoints

  • Direct secure messaging: shavkat.ruziev@1069632563511300.direct.elationemr.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1578724308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 ISABEL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427482",
            "telephone_number": "717-297-7900",
            "fax_number": "717-276-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 ISABEL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427482",
            "telephone_number": "717-297-7900",
            "fax_number": "717-273-7323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Linglestown Rd",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171121017",
            "country_code": "US",
            "telephone_number": "717-231-8867",
            "fax_number": "717-221-5219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 Bloomfield Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lititz",
            "state": "PA",
            "postal_code": "175437788",
            "country_code": "US",
            "telephone_number": "717-297-7900",
            "fax_number": "717-276-7323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUZIEV",
        "first_name": "SHAVKAT",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD445750",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "204756",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1160652",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102757120",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.