Individual provider Active NPI

Patrick Rutka, D.O.

  • Internal Medicine Physician
  • Greenport, NY
National Provider Identifier
1528599099
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
303303 Issued in NY
Practice address
201 Manor PL
Greenport, NY 11944-1222
Phone
(631) 477-5273
Fax
(631) 477-1670
NPI assigned
Mar 25, 2017
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 303303 NY Primary

Addresses

Primary practice location

201 Manor PL
Greenport, NY 11944-1222

Mailing address

240 Meeting House LN
Southampton, NY 11968-5009
Phone (860) 705-1575

Other practice location 1

240 Meeting House Ln
Southampton, NY 11968-5009
Phone (860) 705-1575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200605000514 NY Practitioner - HospitalistPractitioner - Internal Medicine 0941621668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 726-8717

325 Meeting House LN
Southampton, NY 11968-7000

3330 Noyac Rd
Sag Harbor, NY 11963-1930
Phone (631) 725-2112

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303303NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC Internal Medicine CurrentSince Jul 14, 2020 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

57 Hampton Rd
Ste 201
Southampton, NY 11968
Phone (631) 283-1126

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1528599099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LN",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119685009",
            "telephone_number": "860-705-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MANOR PL",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119441222",
            "telephone_number": "631-477-5273",
            "fax_number": "631-477-1670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Meeting House Ln",
            "address_purpose": "LOCATION",
            "city": "Southampton",
            "state": "NY",
            "postal_code": "119685009",
            "country_code": "US",
            "telephone_number": "860-705-1575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTKA",
        "first_name": "PATRICK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-25",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "303303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenport, NY

Sources for this page

Verify at the official NPI Registry.