Active NPI
Nadiya Rutman, RN BSN/ CNP
- Nurse Practitioner
- Lynn, MA
National Provider Identifier
1215475918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN2306741
- Practice address
- 235 Woodland N
Lynn, MA 01904-1414 - Phone
- (781) 632-8080
- NPI assigned
- Feb 2, 2017
- Last updated
- Dec 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN2306741 | MA | Primary |
Addresses
Primary practice location
235 Woodland N
Lynn, MA 01904-1414
Mailing address
2 Gracie LN Unit 2
Swampscott, MA 01907-2357
Phone (781) 632-8080
Other practice location 1
100 Highland Ave
Salem, MA 01970-2702
Phone (781) 244-0115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190529000512 | MA | Order and Referring Only - Geriatric Medicine | 2668715046 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor on Science - Nursing, Certified Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Psychiatric Associates Inc | Past | Accepting new patients |
Interoperability endpoints
- nadiya.rutman.p1@direct.elementcare.nextgenshare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Salem, MA
- NPI 1831205608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1215475918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 GRACIE LN UNIT 2",
"city": "SWAMPSCOTT",
"state": "MA",
"postal_code": "019072357",
"telephone_number": "781-632-8080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 WOODLAND N",
"city": "LYNN",
"state": "MA",
"postal_code": "019041414",
"telephone_number": "781-632-8080"
}
],
"practiceLocations": [
{
"address_1": "100 Highland Ave",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "MA",
"postal_code": "019702702",
"country_code": "US",
"telephone_number": "781-244-0115",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUTMAN",
"first_name": "NADIYA",
"credential": "RN BSN/ CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-02",
"last_updated": "2023-12-19",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN2306741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.