Individual provider Active NPI

Rutika Agrawal

  • Dentist
  • Reading, PA
National Provider Identifier
1255758348
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS039995 Issued in PA
Practice address
3302 N 5TH Street Hwy
Reading, PA 19605-2427
Phone
(610) 929-4040
NPI assigned
Mar 26, 2014
Last updated
Jun 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS039995 PA Primary

Addresses

Primary practice location

3302 N 5TH Street Hwy
Reading, PA 19605-2427

Mailing address

350 N Clark St
6TH Floor
Chicago, IL 60654-4712
Phone (312) 274-4520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519002543 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1658660279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS039995PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentist of Paoli Inc Current Accepting new patients
Orange Dental Inc Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1255758348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST",
            "address_2": "6TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712",
            "telephone_number": "312-274-4520",
            "fax_number": "312-803-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 N 5TH STREET HWY",
            "city": "READING",
            "state": "PA",
            "postal_code": "196052427",
            "telephone_number": "610-929-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRAWAL",
        "first_name": "RUTIKA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.