Mark Louis Ruggeri, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052793 Issued in NY

Practice address

1839 N Railroad Ave
Staten Island, NY 10306-2020

Phone

(718) 979-2121

NPI assigned

May 10, 2007

Last updated

Mar 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331337600000",
    "number": "1639383169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 N RAILROAD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062020",
            "telephone_number": "718-979-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 N RAILROAD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062020",
            "telephone_number": "718-979-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGERI",
        "first_name": "MARK",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2012-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Alissa Rudman, PT
• Viktoriya Rudnik, O.D.
• Simone Rudnin, DO
• Wendy Ruffin
• Adrianna Angela Ruffo
• Christina Ruggieri
• Adriana Marie Ruggiero
• Lucille Ruggiero
• Mary Ruggiero, MD
• Nicholas Ruggiero, PA-C

• General Practice Dentistry in Staten Island, NY
• Providers in Staten Island, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2012; 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.

Verify at the official NPI Registry.