NPIMap

Organization Active NPI

Advanced Dermatology Center, PC

Doing business as Ronald Jurzyk MD

  • Dermatology Physician
  • Wolcott, CT
National Provider Identifier
1639160294
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
035267 Issued in CT
Legal business name
ADVANCED DERMATOLOGY CENTER, PC
Doing business as
Advanced Dermatology Center, PC
Ronald Jurzyk MD
Practice address
464 Wolcott Rd
Wolcott, CT 06716-2626
Phone
(203) 879-6171
Fax
(203) 879-1191
NPI assigned
Nov 2, 2005
Last updated
Aug 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Authorized official

Name
Ronald S. Jurzyk, MDNPI 1215910922
Title
Owner
Phone
(203) 879-6171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 035267 CT Primary

Addresses

Primary practice location

464 Wolcott Rd
Wolcott, CT 06716-2626

Mailing address

464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171

Other names 2

  • Advanced Dermatology Center, PC Doing business as
  • Ronald Jurzyk MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000894 CT Part B Supplier - Clinic/Group Practice 5294623005 Receives reassigned benefits from 4 practitioners
Practice locations: Wolcott, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1639160294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162626",
            "telephone_number": "203-879-6171",
            "fax_number": "203-879-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162626",
            "telephone_number": "203-879-6171",
            "fax_number": "203-879-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "JURZYK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-879-6171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CT",
            "license": "035267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology Center, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ronald Jurzyk MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ronald Jurzyk MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wolcott, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.