Jet Thanetr Ruttanasee, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV 007165 Issued in NY

Practice address

7010 Austin St Ste 2
Forest Hills, NY 11375-4763

Phone

(718) 575-8288

NPI assigned

Sep 20, 2007

Last updated

Feb 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MK Vision Center I, Inc

  • Optometrist
  • Forest Hills, NY
  • NPI 1760095384
  Medicare reassignment NPD
• MK Vision Center

  • Optometrist
  • Forest Hills, NY
  • NPI 1528372901
  NPD

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1396931689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 72ND RD",
            "address_2": "APT. 605",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755471",
            "telephone_number": "347-901-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 AUSTIN ST STE 2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754763",
            "telephone_number": "718-575-8288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10729 71st Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113754724",
            "country_code": "US",
            "telephone_number": "718-575-8288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTTANASEE",
        "first_name": "JET",
        "middle_name": "THANETR",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2021-02-02",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV 007165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03086528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Russell
• Victoria Luz Russo, RN
• Ozodakhon Rustamova
• Stanley Rustin, PH.D.
• Joanne Rutland
• S and B Optometry Care, P.C. (The Gardens Eye Care)
• Stacy Saavedra de Ortega
• Natalya Sachkova, MA
• Amnon Eric Sadeh, MD
• Oren Sadeh, DPM

• Optometrist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.