Individual provider Active NPI

Allison Elizabeth Schuelke Rutelonis, RN, BSN, MSN, FNP-C

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1407340128
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP138722 Issued in TX
Practice address
1128 Medical Dr
Tyler, TX 75701
Phone
(903) 593-8273
NPI assigned
Jun 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP138722 TX Primary

Addresses

Primary practice location

1128 Medical Dr
Tyler, TX 75701

Mailing address

Dept. 453, PO Box 1000
Memphis, TN 38148-0001
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
1407340128MedicaidTX
759811OtherTXMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190131003145 TX Practitioner - Nurse Practitioner 3173860921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

805 Medical Cir
Longview, TX 75605-5130
Phone (903) 232-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP138722TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinicians of East Texas CurrentSince Jun 12, 2023 Accepting new patients
Allergy Partners of Texas, Inc. CurrentSince Feb 1, 2019 Accepting new patients
Allergy Partners of Texas, Inc Current Accepting new patients
Allergy Partners of Texas, Inc. CurrentSince Feb 1, 2019 Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients
Allergy Partners, PLLC Past Accepting new patients

Locations

760 N Shiloh Rd
Garland, TX 75042
Phone (972) 272-4463

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

805 Medical Cir
Longview, TX 75605
Phone (903) 232-8100

801 Medical Cir
Ste A
Longview, TX 75605
Phone (903) 593-8273

1128 Medical Dr
Tyler, TX 75701
Phone (903) 593-8273

Interoperability endpoints

  • Direct secure messaging: allison.rutelonis.1@23550.direct.athenahealth.com

Organizations & group practices 6

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": "1529107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1407340128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 453, PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-593-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTELONIS",
        "first_name": "ALLISON",
        "middle_name": "ELIZABETH SCHUELKE",
        "credential": "RN, BSN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-16",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP138722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407340128",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "759811",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.