Individual provider Active NPI

Aubrey Ruttman, PA

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1407539588
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2026017912 Issued in MO
Practice address
4321 Washington St Ste 5300
Kansas City, MO 64111-5931
Phone
(816) 531-1234
Fax
(816) 531-0737
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2026017912 MO Primary

Addresses

Primary practice location

4321 Washington St Ste 5300
Kansas City, MO 64111-5931

Mailing address

4321 Washington St Ste 5300
Kansas City, MO 64111-5931
Phone (816) 531-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260624000652 KS Practitioner - Physician Assistant 1951874783 Reassigns benefits to 1 organization
I20260624000834 MO Practitioner - Physician Assistant 1951874783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3102 Woodview Ridge Dr
Apt 302
Kansas City, KS 66103-3634

8551 Bluejacket St
Lenexa, KS 66214-1656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2026017912MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas City Urology Care, P.a. CurrentSince Jun 17, 2026 Accepting new patients

Locations

7450 W Frontage Rd
Shawnee, KS 66203
Phone (913) 319-7600

4321 Washington St
Ste 5300
Kansas City, MO 64111
Phone (816) 531-1234

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1407539588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST STE 5300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115931",
            "telephone_number": "816-531-1234",
            "fax_number": "816-531-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST STE 5300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115931",
            "telephone_number": "816-531-1234",
            "fax_number": "816-531-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTMAN",
        "first_name": "AUBREY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2026017912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.