Individual provider Active NPI

Maryanne Waugh Rutz

  • Certified Registered Nurse Anesthetist
  • Buffalo, NY
National Provider Identifier
1558005264
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
766207 Issued in NY
Practice address
2950 Elmwood Ave
Buffalo, NY 14217-1304
Phone
(785) 640-8252
NPI assigned
Apr 27, 2022
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 766207 NY Primary
Specialist 174400000X NU

Addresses

Primary practice location

2950 Elmwood Ave
Buffalo, NY 14217-1304

Mailing address

136 Woodward Dr
Buffalo, NY 14224-3532
Phone (785) 640-8252

Other practice location 1

818 Ellicott St
Buffalo, NY 14203-1021
Phone (785) 640-8252

Other names 1

  • Mary Anne Rutz Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603002150 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800274747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Anesthesiology PCGroup PAC ID 7113997529, 90 clinicians

Practice addresses (Care Compare)

818 Ellicott St
Buffalo, NY 14203-1021
Phone (716) 323-6570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
766207NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesiology, PC Specialist CurrentSince Jul 1, 2022 Accepting new patients

Locations

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

Organizations & group practices 1

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 3

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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1558005264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 WOODWARD DR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142243532",
            "telephone_number": "785-640-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "785-640-8252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Ellicott St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031021",
            "country_code": "US",
            "telephone_number": "785-640-8252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTZ",
        "first_name": "MARYANNE",
        "middle_name": "WAUGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "766207",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "RUTZ",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.