Individual provider Active NPI

Cheryl Rutkauskas

  • Registered Dietitian
  • Allentown, PA
National Provider Identifier
1487042487
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN003915 Issued in PA
Practice address
1243 S Cedar Crest Blvd
Ste 2200
Allentown, PA 18103-6268
Phone
(610) 402-2500
Fax
(610) 402-2506
NPI assigned
Dec 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN003915 PA Primary

Addresses

Primary practice location

1243 S Cedar Crest Blvd
Ste 2200
Allentown, PA 18103-6268

Mailing address

PO Box 1754
Allentown, PA 18105-1754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150203000788 PA Practitioner - Registered Dietitian Or Nutrition Professional 8921323585 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN003915PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2015 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2015 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients

Locations

2100 Mack Blvd
Fl 2
Allentown, PA 18103

1243 S Cedar Crest Blvd
Ste 2200
Allentown, PA 18103
Phone (610) 402-2500

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 4

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": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1487042487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1754",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 S CEDAR CREST BLVD",
            "address_2": "STE 2200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036268",
            "telephone_number": "610-402-2500",
            "fax_number": "610-402-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKAUSKAS",
        "first_name": "CHERYL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN003915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.