DR. JESSICA MARIE LUCKENBAUGH RUBERTONE MD
NPI 1225298524
Family Medicine in Mechanicsburg, PA

Q: What is Jessica Luckenbaugh Rubertone's NPI number?

The NPI number for Jessica Luckenbaugh Rubertone is 1225298524. It was assigned to this individual provider in the NPPES registry on June 11, 2008.

Q: What is Jessica Luckenbaugh Rubertone's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: Is Jessica Luckenbaugh Rubertone enrolled in Medicare?

No. Jessica Luckenbaugh Rubertone has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since June 11, 2008Opted out of Medicare · through Apr 1, 2027

82.54/100

CMS Quality Rating

1 KACEY CT, SUITE 101, MECHANICSBURG, PA 17055(717) 591-0961(717) 591-0980 Get Directions Write a Review

NPPES record last updated: August 19, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jessica Marie Luckenbaugh Rubertone Md NPPES

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

DR. JESSICA MARIE LUCKENBAUGH RUBERTONE MD (NPI 1225298524) is an individual family medicine provider in Mechanicsburg, Pennsylvania, licensed in Pennsylvania (MD442929) and active in the NPI registry since June 2008. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1225298524

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JESSICA MARIE LUCKENBAUGH RUBERTONECredential: MD

Location Address1 KACEY CT, SUITE 101Mechanicsburg, PA 17055-9223

Mailing Address3 Walnut St, Suite 206Lemoyne, PA 17043-1168 · (717) 761-0208 · Fax (717) 761-2023

Phone(717) 591-0961

Fax(717) 591-0980

Sole ProprietorNo

Enumeration DateJune 11, 2008

Last NPPES UpdateAugust 19, 2011

✔ NPI 1225298524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in PA · MD442929

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1 KACEY CT, Mechanicsburg, PA 17055

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jessica Marie Luckenbaugh Rubertone Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2023 through April 1, 2027.

Opt-Out Effective DateApril 1, 2023

Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17055 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

$84.88 typical visit price

range $54.64 – $166.87

Typical copayment $21.22 (range $13.66 – $41.71)

Most-billed visit code 99203

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.54/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

76.62

Promoting Interoperability

100

Improvement Activities

Cost

65.18

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers15 claims42 services$4.58 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers12 claims12 services$35.53 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

4 suppliers11 claims11 services$94.79 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

5 suppliers12 claims33 services$32.80 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers15 claims15 services$51.38 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers14 claims14 services$18.38 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

HERITAGE MEDICAL GROUP, LLP

Family Medicine