Charles Hugh Rutan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002266A Issued in IN

Practice address

224 Elm St
Clinton, IN 47842-2312

Phone

(765) 832-3292

Fax

(765) 832-9730

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

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

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crutan@advantageeyecare.eyefinity-direct.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Ray Rutan, O.D.

  • Optometrist
  • Fort Wayne, IN
  • NPI 1588630149
  Medicare reassignment

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.

• Charles H. Rutan, O.D.

  • Eyewear Supplier
  • Clinton, IN
  • NPI 1639347743

  Optometrist

  NPD Authorized official

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1487643268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 ELM ST",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478422312",
            "telephone_number": "765-832-3292",
            "fax_number": "765-832-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ELM ST",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478422312",
            "telephone_number": "765-832-3292",
            "fax_number": "765-832-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTAN",
        "first_name": "CHARLES",
        "middle_name": "HUGH",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002266A",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IN",
            "license": "18002266A",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "IN",
            "license": "1800226A",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IN",
            "license": "18002266A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "351776119",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000087765",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LOCATION C",
            "identifier": "100243930C",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100243930",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Rivera
• Jennifer Roach, LMHC
• Carol Adrienne Robinson, LACA
• Sandra Faye Rogers, FNP
• Bethany Anne Rose, PHARMD
• Jordan Ryley, NP
• S & S Medical LLC
• Brenda E Seibold, FNP
• Anjila Shrestha, DMD
• Cierra Smith

• Optometrist in Clinton, IN
• Providers in Clinton, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.