Individual provider Active NPI

Adam Arnold Rutkowski, DC

  • Chiropractor
  • Euclid, OH
National Provider Identifier
1073626602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1813 Issued in OH
Practice address
22308 Lakeshore Blvd
Euclid, OH 44123
Phone
(216) 289-2500
Fax
(216) 289-2585
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1813 OH Primary

Addresses

Primary practice location

22308 Lakeshore Blvd
Euclid, OH 44123

Mailing address

22308 Lakeshore Blvd
Euclid, OH 44123
Phone (216) 289-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000181 OH Practitioner - Chiropractic 1951586023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22308 Lake Shore Blvd
Euclid, OH 44123-1717
Phone (216) 289-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1813OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine and Chiropractic Rehabilitation LLC Chiropractor CurrentSince Dec 11, 2010 Accepting new patients

Locations

22308 Lake Shore Blvd
Euclid, OH 44123
Phone (216) 289-2500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073626602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22308 LAKESHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "44123",
            "telephone_number": "216-289-2500",
            "fax_number": "216-289-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22308 LAKESHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "44123",
            "telephone_number": "216-289-2500",
            "fax_number": "216-289-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "ADAM",
        "middle_name": "ARNOLD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.