RORY MACK RUSKOVICH (NPI# 1679199863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679199863 |
| Entity Type | Individual |
| Full Name | RORY MACK RUSKOVICH |
| Credential | PA-C |
| Practice Address |
277 Ohua Ave Honolulu HI 96815-3695 |
| Mailing Address |
71 Paradise Rd Grangeville ID 83530-5321 |
| Practice Telephone | 8089224787 |
| Practice Fax Number | 8089224950 |
| Mailing Telephone | 2088192476 |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
277 OHUA AVE |
| City | HONOLULU |
| State | HI |
| Zip Code | 96815-3695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144202870 | Elliot J Kalauawa | Internal Medicine | 277 Ohua Ave, Honolulu, HI 96815-3643 | 2005-11-17 |
| 1518566272 | Kelli Ann Sayoko Nakamura | Physician Assistant | 277 Ohua Ave, Honolulu, HI 96815-6612 | 2020-10-22 |
| 1922619709 | Jinny Gi Hae Ching | Nurse Practitioner | 277 Ohua Ave, Honolulu, HI 96815-3695 | 2020-08-13 |
| 1659982726 | Leif Alexander Marz | Nurse Practitioner | 277 Ohua Ave, Honolulu, HI 96815-6612 | 2020-08-12 |
| 1396391983 | Gabrielle Genevieve Garcia | Physician Assistant | 277 Ohua Ave, Honolulu, HI 96815-3695 | 2019-08-10 |
| 1760037089 | Joycelyn Chun | Physician Assistant | 277 Ohua Ave, Honolulu, HI 96815-6612 | 2019-08-04 |
| 1699271734 | Sarah Elizabeth Grabill | Nurse Practitioner | 277 Ohua Ave, Honolulu, HI 96815-3695 | 2018-04-05 |
| 1437654308 | Rebecca Claire Fojas-calimpong | Nurse Practitioner | 277 Ohua Ave, Honolulu, HI 96815 | 2018-03-24 |
| 1578081071 | Lindsey Abrams Torres | Nurse Practitioner | 277 Ohua Ave, Honolulu, HI 96815-6612 | 2017-09-05 |
| 1083149892 | United Self Help | Non-emergency Medical Transport (VAN) | 277 Ohua Ave, Room 205 H, Honolulu, HI 96815-6612 | 2017-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861956609 | Kristen Nicole Sutton | Counselor | 1888 Kalakaua Ave., Suite C312, Honolulu, HI 96815 | 2019-01-25 |
| 1760954192 | Mie Takizawa Lilavois | Nurse Practitioner | 120 Ka'iulani Ave, #kw 10&11, Honolulu, HI 96815 | 2018-12-25 |
| 1588131320 | Queen's Development Corporation and Subsidiaries | Clinic/Center | 449 Kapahulu Avenue, Suite 104, Honolulu, HI 96815 | 2018-10-30 |
| 1679906614 | Stephen Anthony Reynolds | Psychologist | 1684 Ala Moana Blvd Apt 252, Honolulu, HI 96815 | 2013-08-13 |
| 1275974834 | Sean David Tarrant | Behavioral Analyst | 456 Keoniana St Apt 304, Honolulu, HI 96815 | 2013-07-11 |
| 1679841928 | Saki Kimura | Physical Therapist | 120 Kaiuiani Ave., # Kw 10 & 11, Honolulu, HI 96815 | 2011-12-01 |
| 1376782243 | Ed G Fess | Preventive Medicine | 3038 La Pietra Cir, Honolulu, HI 96815 | 2009-02-16 |
| 1386813095 | Cck Daniel LLC | Family Medicine | 460 Ena Road, #603, Honolulu, HI 96815 | 2008-02-27 |
| 1932377751 | Ryan Koichi Frasco | Dentist | 3358 Campbell Avenue, Honolulu, HI 96815 | 2008-02-14 |
| 1952522609 | Stephen Richard Ho | Dentist | 438 Hobron Lane, Ste 209, Honolulu, HI 96815 | 2007-05-01 |
| Find all providers in zip 96815 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433505 | Jessica Renae Hall | Physician Assistant | 201 Bougainvillea Loop, Honolulu, HI 96818-1495 | 2020-10-08 |
| 1568076685 | Emily Rose Callaway | Physician Assistant | 501 Hahaione St Apt 8j, Honolulu, HI 96825-1444 | 2020-09-04 |
| 1982161782 | Amanda Laurent | Physician Assistant | 1401 S Beretania St Ste 102, Honolulu, HI 96814-1871 | 2019-02-28 |
| 1720578693 | Ashley Marie Mccall | Physician Assistant | 900 Fort Street Mall Ste 1040, Honolulu, HI 96813-3701 | 2018-05-15 |
| 1154835353 | Arthur Burgos Domingo | Physician Assistant | 445 Seaside Ave, Honolulu, HI 96815-2640 | 2017-11-27 |
| 1922400142 | Kumiko Imai | Physician Assistant | 1456 Thurston Ave, Apt1104, Honolulu, HI 96822-3682 | 2014-09-18 |
| 1447694179 | Christopher Henry Rossetti | Physician Assistant | 1253 Makalapa Road, Honolulu, HI 96817 | 2013-04-24 |
| 1003150368 | Mandi Sue Breyman | Physician Assistant | 1329 Lusitana St Ste 202, Honolulu, HI 96813-2401 | 2012-11-26 |
| 1831336817 | Isabel Dorotea Hung Wan | Physician Assistant | 550 S. Beretania St., #405, Honolulu, HI 96813 | 2009-01-13 |
| 1437308111 | Kathleen Louise Elliott | Physician Assistant | 2045 Alaeloa St, Honolulu, HI 96821-1020 | 2008-09-17 |
| Find all providers in HONOLULU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.