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MR. KENNETH BRIAN RUSANOWSKI DDS
NPI 1174675185
Dentist - Periodontics in Santa Fe, NM

Active since January 18, 2007PECOS Enrolled
2 CALLE MEDICO, STE 2, SANTA FE, NM 87505(505) 988-2611(505) 820-0397 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Kenneth Brian Rusanowski Dds NPPES

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

MR. KENNETH BRIAN RUSANOWSKI DDS (NPI 1174675185) is an individual periodontics provider in Santa Fe, New Mexico, licensed in New Mexico (DD1585) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174675185
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameMR. KENNETH BRIAN RUSANOWSKICredential: DDS
Location Address2 CALLE MEDICO, STE 2Santa Fe, NM 87505
Mailing Address2 Calle Medico, Ste 2Santa Fe, NM 87505 · (505) 988-2611 · Fax (505) 820-0397
Phone(505) 988-2611
Fax(505) 820-0397
Sole ProprietorNo
Enumeration DateJanuary 18, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174675185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in NM · DD1585
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
2 CALLE MEDICO, Santa Fe, NM 87505
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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)

Mr. Kenneth Brian Rusanowski Dds 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 87505 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
Most-billed visit code 99213
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

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

ERICK F CARLGREN DDS
Dentist (Endodontics)
2 CALLE MEDICO, SUITE 3
SANTA FE, NM 87505
Santa Fe County (505) 982-4592

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 Kenneth Rusanowski's NPI number?

The NPI number for Kenneth Rusanowski is 1174675185. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Kenneth Rusanowski located?

Kenneth Rusanowski practices at 2 Calle Medico Ste 2, Santa Fe, NM 87505. The listed phone number is (505) 988-2611.

What is Kenneth Rusanowski's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Kenneth Rusanowski enrolled in Medicare?

Yes. Kenneth Rusanowski is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Rusanowski was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.