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JACK WILLIAM RUSKE MD
NPI 1124878012
Internal Medicine in Salt Lake City, UT

Active since March 25, 2024PECOS Enrolled
30 N 1900 E, SALT LAKE CITY, UT 84132(801) 581-7606 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack William Ruske Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK WILLIAM RUSKE MD (NPI 1124878012) is an individual internal medicine provider in Salt Lake City, Utah, licensed in Utah (14246307-1205) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124878012
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJACK WILLIAM RUSKECredential: MD
Location Address30 N 1900 ESalt Lake City, UT 84132-0002
Mailing Address30 N 1900 ESalt Lake City, UT 84132-0002 · (617) 710-4466
Phone(801) 581-7606
Sole ProprietorNo
Enumeration DateMarch 25, 2024
Last NPPES UpdateOctober 29, 2025
NPPES CertifiedOctober 29, 2025
✔ NPI 1124878012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in UT · 14246307-1205
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
30 N 1900 E, Salt Lake City, UT 84132
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack William Ruske Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANNE WIERMAN ESTARES D.O.
Anesthesiology
30 N 1900 E, RM 4C104
SALT LAKE CITY, UT 84132
Salt Lake County (719) 314-5254
DR. JEFFREY DAVID DILLON M.D.
Anesthesiology
30 N 1900 E, ROOM 3C444
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6393
QUINTON ALLRED PA-C
Physician Assistant (Medical)
30 N 1900 E
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7822
JEREMY ROYLE STODDART MD
Psychiatry & Neurology (Psychiatry)
30 N 1900 E, UNIVERSITY HOSPITAL,
SLC, UT 84132
Salt Lake County (801) 581-2121
DR. STEPHEN JAMES SUMMERS M.D.
Urology
30 N 1900 E, RM 3B420
SALT LAKE CITY, UT 84132
Salt Lake County (801) 213-2700
CHRISTINA MARIE DERBIDGE PHD
Psychologist (Clinical)
30 N 1900 E, ROOM SOM 1-B620
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6228
ANDRIA HOLMES HOLT RN
Nurse Practitioner (Obstetrics & Gynecology)
30 N 1900 E
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7647
ANDY NGUYEN
Internal Medicine
30 N 1900 E, SOM4C104
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7899

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Ruske's NPI number?

The NPI number for Jack Ruske is 1124878012. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Where is Jack Ruske located?

Jack Ruske practices at 30 N 1900 E, Salt Lake City, UT 84132. The listed phone number is (801) 581-7606.

What is Jack Ruske's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack Ruske enrolled in Medicare?

Yes. Jack Ruske is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Ruske was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.