Active NPI
Kathleen Laura Jedruszczuk, DO
- Dermatology Physician
- Rutherford, NJ
National Provider Identifier
1598405870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 25MB13233000
- Practice address
- 75 Orient Way Ste 204
Rutherford, NJ 07070-2086 - Phone
- (201) 623-8000
- Fax
- (201) 578-5160
- NPI assigned
- Apr 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 25MB13233000 | NJ | Primary |
Addresses
Primary practice location
75 Orient Way Ste 204
Rutherford, NJ 07070-2086
Mailing address
75 Orient Way Ste 204
Rutherford, NJ 07070-2086
Phone (201) 623-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1598405870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 ORIENT WAY STE 204",
"city": "RUTHERFORD",
"state": "NJ",
"postal_code": "070702086",
"telephone_number": "201-623-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 ORIENT WAY STE 204",
"city": "RUTHERFORD",
"state": "NJ",
"postal_code": "070702086",
"telephone_number": "201-623-8000",
"fax_number": "201-578-5160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDRUSZCZUK",
"first_name": "KATHLEEN",
"middle_name": "LAURA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-01",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NJ",
"license": "25MB13233000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rutherford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.