Individual provider Active NPI

Robert J Ruskiewicz, MD

  • Psychiatry Physician
  • Milwaukee, WI
National Provider Identifier
1639185564
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
27783020 Issued in WI
Practice address
2020 W Wells St
Milwaukee, WI 53233-2720
Phone
(414) 476-9675
Fax
(414) 755-1834
NPI assigned
Jul 31, 2006
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 27783020 WI Primary

Addresses

Primary practice location

2020 W Wells St
Milwaukee, WI 53233-2720

Mailing address

1040 S 70TH Street
Milwaukee, WI 53214
Phone (414) 476-9675

Other identifiers 1

IdentifierTypeStateIssuer
31503600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20060425000291 WI Practitioner - Psychiatry 6204846058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Wisconsin, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2020 W Wells St
Milwaukee, WI 53233-2720
Phone (414) 476-9675

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27783020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Milwaukee CurrentSince Apr 1, 2013 Accepting new patients
Milwaukee Center for Independence Inc Current Accepting new patients
County of Milwaukee Psychiatry CurrentSince Apr 1, 2013 Accepting new patients
County of Milwaukee Current Accepting new patients
Apps Chiropractic and Wellness Center Inc Past Accepting new patients

Locations

1220 W Vliet St
Milwaukee, WI 53205
Phone (414) 257-7475

2020 W Wells St
Milwaukee, WI 53233
Phone (414) 476-9675

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1639185564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S 70TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-476-9675",
            "fax_number": "414-615-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332720",
            "telephone_number": "414-476-9675",
            "fax_number": "414-755-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSKIEWICZ",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "27783020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31503600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.