Rory Mack Ruskovich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

AMD-998 Issued in HI

Practice address

91-6390 Kapolei Pkwy Ste 200
Ewa Beach, HI 96706-6380

Phone

(808) 691-8200

NPI assigned

Jun 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.05 of 100Reported as apm

Quality

89.81

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group
• Waikiki Health

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1679646509
  Medicare reassignment NPD (past)
• Primary Care Physician Enterprise LLC

  • Clinic/Center
  • Ewa Beach, HI
  • NPI 1164054763
  NPD
• Waikiki Health

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1528359791
  NPD

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1679199863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY STE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066380",
            "telephone_number": "808-691-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY STE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066380",
            "telephone_number": "808-691-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Ohua Ave",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968153695",
            "country_code": "US",
            "telephone_number": "808-922-4787",
            "fax_number": "808-922-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSKOVICH",
        "first_name": "RORY",
        "middle_name": "MACK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-998",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale Frederick Rosskamp
• Emily Rosskopf
• Redentor Cagumoc Rous
• Aga Marnette Roxas, RN
• Andrew Justin Ruege, M.D.
• Russell S Kelly MD LLC
• Jacob D Russell, DC
• Natalie Sabino
• Suzzana June Saelua
• Safeway Inc

• Physician Assistant in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.