Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rory Mack Ruskovich, PA-C

Individual provider Physician Assistant · NPI 1679199863

Rory Mack Ruskovich, PA-C is a Physician Assistant in Ewa Beach, Hawaii. Qualified in 2020, 6 years ago. Practices with Queens University Medical Group, a 623-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Hawaii.

Years since qualifying
6
Licensed in
HI
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

91-6390 Kapolei Pkwy Ste 200
Ewa Beach, HI 96706-6380
Phone: (808) 691-8200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 277 Ohua Ave, Honolulu, HI 96815-3695 — (808) 922-4787

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence AMD-998 (HI)
Registered Dietitian Taxonomy 133V00000X

Record details

NPI number1679199863
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 23, 2020
Last updated in NPPESJune 27, 2023
Certification dateJune 27, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Queens University Medical Group — 623 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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