Organization Active NPI

Rutzen Eye Specialists

  • Ophthalmology Physician
  • Severna Park, MD
National Provider Identifier
1114137841
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0051102 Issued in MD
Legal business name
RUTZEN EYE SPECIALISTS
Practice address
489 Ritchie Highway
Suite 200
Severna Park, MD 21146-2910
Phone
(410) 975-0090
Fax
(410) 975-0089
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. Allan Richard Rutzen, M.D.NPI 1700837192
Title
President
Phone
(410) 975-0090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X D0051102 MD Primary

Addresses

Primary practice location

489 Ritchie Highway
Suite 200
Severna Park, MD 21146-2910

Mailing address

489 Ritchie Highway
Suite 200
Severna Park, MD 21146-2910
Phone (410) 975-0090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071003000237 MD Part B Supplier - Clinic/Group Practice 9032204524 Receives reassigned benefits from 4 practitioners
Practice locations: Severna Park, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1114137841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 RITCHIE HIGHWAY",
            "address_2": "SUITE 200",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462910",
            "telephone_number": "410-975-0090",
            "fax_number": "410-975-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 RITCHIE HIGHWAY",
            "address_2": "SUITE 200",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462910",
            "telephone_number": "410-975-0090",
            "fax_number": "410-975-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTZEN EYE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "RUTZEN",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-975-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0051102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.