Individual provider Active NPI

Jeffrey Jay Rutgard, M.D.

  • Ophthalmology Physician
  • Mililani, HI
National Provider Identifier
1366795155
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD16420 Issued in HI
Practice address
95-717 Kipapa Drive #23
Mililani, HI 96789
Phone
(808) 888-6217
NPI assigned
Oct 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD16420 HI Primary

Addresses

Primary practice location

95-717 Kipapa Drive #23
Mililani, HI 96789

Mailing address

95-717 Kipapa Drive #23
Mililani, HI 96789
Phone (808) 888-6217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD16420HIMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1366795155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-717 KIPAPA DRIVE #23",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-888-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-717 KIPAPA DRIVE #23",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "96789",
            "telephone_number": "808-888-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTGARD",
        "first_name": "JEFFREY",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD16420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.