Michael David Rutkowski, MD.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

177347 Issued in NY

Practice address

104 Union Avenue
Suite 806-807
Syracuse, NY 13203

Phone

(315) 474-0542

Fax

(315) 474-4340

NPI assigned

Jul 7, 2006

Last updated

Jan 9, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Medicare reassignment NPD
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747

  Internal Medicine

  Medicare reassignment NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070

  Internal Medicine

  NPD
• St Joseph's Hospital Health Center

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1699832436
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1568495380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WEST TAFT ROAD",
            "address_2": "SUITE L",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-452-2500",
            "fax_number": "315-452-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 UNION AVENUE",
            "address_2": "SUITE 806-807",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-474-0542",
            "fax_number": "315-474-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "177347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01129799",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steve Kalisa Rutagarama, FNP
• Yvonne U. Rutagarama, NP
• Daniel Ian Ruter, MD
• Dana Marie Ruth, NP
• Kasey E Ruthven
• Linda Ruzza
• Ellan Ryan-Draper, LCSW, LMSW
• Catherine Anne Ryan, LCSW
• Danielle L Ryan, FNP-C
• Devon Ryan, MD

• Internal Medicine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.