Paul Andrew Rusonis, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0030058 Issued in MD

Practice address

6021 University Blvd
Suite 390
Ellicott City, MD 21043-6077

Phone

(410) 203-0607

Fax

(410) 203-0677

NPI assigned

Mar 17, 2006

Last updated

Oct 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Dermatology Group, LLC

  • Dermatology Physician
  • Columbia, MD
  • NPI 1902327950
  Medicare reassignment NPD
• Integrated Dermatology Group, LLC

  • Dermatology Physician
  • Brighton, MA
  • NPI 1265941082
  NPD
• Dermatology & Advanced Skin Care, Inc.

  • Dermatology Physician
  • Ellicott City, MD
  • NPI 1962890186
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1922077171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6021 UNIVERSITY BLVD",
            "address_2": "SUITE 390",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436077",
            "telephone_number": "410-203-0607",
            "fax_number": "410-203-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 UNIVERSITY BLVD",
            "address_2": "SUITE 390",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436077",
            "telephone_number": "410-203-0607",
            "fax_number": "410-203-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSONIS",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0030058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marielle L Rubeor, LCSW-C
• Sara Kroll Rubloff, MS
• Gary L. Rudacille, D.D.S
• Michele D Ruetsch, LCSW-C
• Dominick Joseph Ruggiero, PHARMD
• Christie Russo, PHARM D
• Ruth N. Agwuna M.D.P.C
• Ruth Shor-Jannati, LCSW-C, LLC
• Brenda Rutledge, PT
• Rxtour, LLC

• Dermatology Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.