NPIMap

Individual provider Active NPI

Kathleen Ann Rutecki, DO

  • Physical Medicine & Rehabilitation Physician
  • Scarborough, ME
National Provider Identifier
1528564879
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DO3770 Issued in ME
Practice address
92 Campus Dr Ste a
Scarborough, ME 04074-7229
Phone
(207) 885-0011
NPI assigned
Apr 4, 2018
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X DO3770 ME Primary

Addresses

Primary practice location

92 Campus Dr Ste a
Scarborough, ME 04074-7229

Mailing address

92 Campus Dr Ste a
Scarborough, ME 04074-7229

Other practice location 1

9150 Huebner Rd Ste 290
San Antonio, TX 78240-1598
Phone (210) 614-6432

Other practice location 2

18626 Hardy Oak Blvd Ste 300
San Antonio, TX 78258-4228
Phone (210) 614-6432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723002240 ME Practitioner - Physical Medicine and Rehabilitation 0143603787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of New England, College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

92 Campus Dr
Scarborough, ME 04074-7229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.88 of 100Reported as group
Quality
10.99
Promoting interoperability
100
Improvement activities
40
Cost
68.61

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO3770MEMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 12, 2024 Accepting new patients
South Texas Spinal Clinic, P.a. Physical Medicine & Rehabilitation CurrentSince Jul 1, 2022 Accepting new patients
Mainehealth Current Accepting new patients
South Texas Spinal Clinic, P.a. CurrentSince Jul 1, 2022 Accepting new patients
Mainehealth CurrentSince Aug 12, 2024 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

12602 Toepperwein Rd
Ste 212
Live Oak, TX 78233
Phone (210) 657-6948

18626 Hardy Oak Blvd
Ste 300
San Antonio, TX 78258
Phone (210) 293-2922

9150 Huebner Rd
Ste 290
San Antonio, TX 78240
Phone (210) 615-3566

2003 Medical Pkwy
Ste A
San Marcos, TX 78666
Phone (512) 392-5359

Interoperability endpoints

  • Direct secure messaging: krutecki717116@direct.mmc.mainehealth.org
  • FHIR API: https://api.platform.athenahealth.com/935/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1528564879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-885-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9150 Huebner Rd Ste 290",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782401598",
            "country_code": "US",
            "telephone_number": "210-614-6432",
            "fax_number": "210-615-3586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18626 Hardy Oak Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782584228",
            "country_code": "US",
            "telephone_number": "210-614-6432",
            "fax_number": "210-615-3586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTECKI",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ME",
            "license": "DO3770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.