Diane L Ruckert, CRNP
Individual provider Active NPI Adult Health Nurse Practitioner · Frederick, MD
NPI 1720028673 · NPPES record last updated Jul 30, 2019
Key facts
- NPI
- 1720028673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- R115108 (MD)
- Practice address
- 400 W 7TH St
Frederick, MD 21701 - Phone
- (240) 566-3031
- Fax
- (240) 439-8910
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Maryland School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Frederick Health Medical Group LLC
Practice addresses (Care Compare)
400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3990
Hospital & facility affiliations
- Frederick Health Hospice
- Frederick Health Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110421000053 | MD | Practitioner - Nurse Practitioner | 8224213046 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R115108 | MD | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Medical Group LLC | Current |
Accepting new patients | |
| Frederick Health Medical Group LLC | Current | Accepting new patients | |
| Frederick Health Medical Group LLC | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
516 Trail Ave
Frederick, MD 21701
Phone (240) 566-3030
400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300
501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574
516 Trail Ave
Ste C
Frederick, MD 21701
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R115108 | MD | Yes |
Addresses
Primary practice location
400 W 7TH St
Frederick, MD 21701
Mailing address
PO Box 37086
Baltimore, MD 21297-3086
Phone (240) 439-8913
Other practice location 1
516 Trail Ave
Frederick, MD 21701-4942
Phone (240) 566-3030
Other practice location 2
516 Trail Ave
Frederick, MD 21701-4942
Phone (240) 566-3030
Other providers in Frederick, MD
- Alexander Sass Rubin
- Hope Rubin
- Mamie S. Ruble
- Amanda Hunter Ruch
- Jenna Marie Rucker
- Abby Rudesill
- Ariana Ruetten
- Mariah Gladys Ruffin
- Joseph Nathaniel Ruhala
- Chhiar Ruma
All providers in Frederick, MD · Adult Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.