Individual provider Active NPI

Charles James Ruotolo, M.D.

  • Orthopaedic Surgery Physician
  • Massapequa, NY
National Provider Identifier
1255307443
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
216303-1 Issued in NY
Practice address
5500 Merrick Rd
Massapequa, NY 11758-6231
Phone
(516) 795-3033
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 216303-1 NY Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 216303-1 NY

Addresses

Primary practice location

5500 Merrick Rd
Massapequa, NY 11758-6231

Mailing address

5500 Merrick Rd
Massapequa, NY 11758-6231
Phone (516) 795-3033

Other identifiers 1

IdentifierTypeStateIssuer
02175455MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040716000423 NY Practitioner - Orthopedic Surgery 9234118878 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York Medical College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5500 Merrick Rd
Massapequa, NY 11758-6231

Hospital & facility affiliations

  • Nassau University Medical Center Hospital, East Meadow, NY, CCN 330027
  • Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

Merit-based Incentive Payment System (MIPS)

Final score
49.6 of 100Reported as individual
Quality
49.04
Promoting interoperability
0
Improvement activities
40
Cost
66.29

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
57.32
Promoting interoperability
84
Improvement activities
40
Cost
80.25

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
216303-1NYMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics Spine and Sports Medicine LLC CurrentSince Oct 11, 2009 Accepting new patients
Nassau Health Care Corporation CurrentSince Jun 29, 2011 Accepting new patients
Syosset Sasc LLC Current Accepting new patients
Nassau Health Care Corporation Current Accepting new patients
Orthopaedics Spine and Sports Medicine, LLC Orthopaedic Surgery Current Accepting new patients
Orthopaedics Spine and Sports Medicine LLC Orthopaedic Surgery CurrentSince Oct 11, 2009 Accepting new patients
Nassau Health Care Corporation CurrentSince Jun 29, 2011 Accepting new patients
Total Orthopedics Spine and Sports Medicine NJ LLC Orthopaedic Surgery Current Accepting new patients
Orthopaedics Spine and Sports Medicine LLC Past Accepting new patients
The Sports Clinic Orthopaedic Medical Associates, Inc. Orthopaedic Surgery PastSince Aug 1, 1991 Accepting new patients
Total Orthopaedics and Sports Medicine, LLP Orthopaedic Surgery PastSince Jul 28, 2004 Accepting new patients

Locations

2510 Westchester Ave
Ste 100
Bronx, NY 10461
Phone (718) 684-4677

1789 Sheepshead Bay Rd
Brooklyn, NY 11235
Phone (347) 587-1049

2103 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4500

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2339 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 520-3053

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

5500 Merrick Rd
Massapequa, NY 11758
Phone (516) 797-2657

12 Unqua Rd
Massapequa, NY 11758

115 Eileen Way
Syosset, NY 11791
Phone (516) 622-9797

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: charlesruotolo@ossm.allscriptsdirect.net

Organizations & group practices 12

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1255307443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586231",
            "telephone_number": "516-795-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586231",
            "telephone_number": "516-795-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUOTOLO",
        "first_name": "CHARLES",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "216303-1",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "216303-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02175455",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.