Walter F Rutkowsky, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1555 Issued in FL

Practice address

5005 Manatee Avenue West
Bradenton, FL 34209-3857

Phone

(941) 794-1315

Fax

(941) 792-5034

NPI assigned

Oct 27, 2005

Last updated

Feb 26, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

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

Southern College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Care Florida, LLCGroup PAC ID 0749595338, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Vision Care Florida, LLC

  dba Rutkowsky Eyecare

  • Optometrist
  • Bradenton, FL
  • NPI 1366834467
  Medicare reassignment Care Compare group NPD
• Walter F Rutkowsky O D PA

  • Optometrist
  • Bradenton, FL
  • NPI 1730358524
  Authorized official Same address or phone
• SK Retina LLC

  dba SK Retina

  • Retina Specialist (Ophthalmology) Physician
  • Sarasota, FL
  • NPI 1194170779
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1417947680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 MANATEE AVENUE WEST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093857",
            "telephone_number": "941-794-1315",
            "fax_number": "941-792-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 MANATEE AVENUE WEST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093857",
            "telephone_number": "941-794-1315",
            "fax_number": "941-792-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKY",
        "first_name": "WALTER",
        "middle_name": "F",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078099500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4545097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2312704",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "580001115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "19203",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Jean Russell
• Denise Charmaine Russell, RN
• Jerry F Russell Jr.
• Jon Michael Russell
• Justin Lee Russell, PA
• RX FC Inc (Garretts Drugs)
• Carol Lee Rydel, CRNA
• Paul F Ryley Jr.
• Karine Saad
• Geetika Sabharwal, M.D.

• Optometrist in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.