NPIMap

Organization Active NPI

McAllen Rutz Eye Clinic PA

  • Optometrist
  • Hallock, MN
National Provider Identifier
1164533410
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1836 Issued in MN
Legal business name
MCALLEN RUTZ EYE CLINIC PA
Practice address
204 South Atlantic
Hallock, MN 56728
Phone
(218) 843-2663
Fax
(218) 843-2665
NPI assigned
Aug 31, 2006
Last updated
Mar 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Duane R Rutz, OD
Title
Ceo/ President
Phone
(218) 843-2663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1836 MN Primary

Addresses

Primary practice location

204 South Atlantic
Hallock, MN 56728

Mailing address

PO Box 910
204 South Atlantic
Hallock, MN 56728
Phone (218) 843-2663

Other identifiers 1

IdentifierTypeStateIssuer
63520MCOtherMNBCBS

Other names 1

  • McAllen Rutz Optometry Clinic Former legal business name

National Provider Directory

National Provider Directory

Locations

402 3rd St E
Ada, MN 56510
Phone (218) 784-4091

402 3rd St E
Ste 1
Ada, MN 56510
Phone (218) 784-4091

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1164533410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "address_2": "204 SOUTH ATLANTIC",
            "city": "HALLOCK",
            "state": "MN",
            "postal_code": "56728",
            "telephone_number": "218-843-2663",
            "fax_number": "218-843-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 SOUTH ATLANTIC",
            "city": "HALLOCK",
            "state": "MN",
            "postal_code": "56728",
            "telephone_number": "218-843-2663",
            "fax_number": "218-843-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCALLEN RUTZ EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "RUTZ",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/ PRESIDENT",
        "authorized_official_telephone_number": "218-843-2663",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "63520MC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McAllen Rutz Optometry Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hallock, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.