Active NPI
Michael Ruzycky
- Athletic Trainer
- Wrentham, MA
National Provider Identifier
1952782963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2381
- Practice address
- 70 Blackberry Hill Rd
Wrentham, MA 02093-1883 - Phone
- (508) 282-0751
- NPI assigned
- Jun 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2381 | MA | Primary |
Addresses
Primary practice location
70 Blackberry Hill Rd
Wrentham, MA 02093-1883
Mailing address
70 Blackberry Hill Rd
Wrentham, MA 02093-1883
Phone (508) 282-0751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2381 | MA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1952782963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 BLACKBERRY HILL RD",
"city": "WRENTHAM",
"state": "MA",
"postal_code": "020931883",
"telephone_number": "508-282-0751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 BLACKBERRY HILL RD",
"city": "WRENTHAM",
"state": "MA",
"postal_code": "020931883",
"telephone_number": "508-282-0751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUZYCKY",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-16",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "2381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wrentham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.