Individual provider Active NPI

Nicholas Ward Rutledge, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Vero Beach, FL
National Provider Identifier
1669495172
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P02624 Issued in FL
Practice address
1880 37TH Street, Suite 4
Vero Beach, FL 32960-4502
Phone
(772) 569-0081
Fax
(772) 569-0819
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X P02624 FL Primary

Addresses

Primary practice location

1880 37TH Street, Suite 4
Vero Beach, FL 32960-4502

Mailing address

PO Box 99
Vero Beach, FL 32961-0099
Phone (772) 569-0081

Other identifiers 1

IdentifierTypeStateIssuer
65519OtherFLBCBS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040116000863 FL Practitioner - Podiatry 4183529852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian River Podiatry P.a.Group PAC ID 7012120702, 3 clinicians

Practice addresses (Care Compare)

1515 US Hwy 1
Suite 204
Sebastian, FL 32958-1612
Phone (772) 569-0081

1880 37TH St
Suite 4
Vero Beach, FL 32960-6594

Hospital & facility affiliations

  • Health at Home Home health agency, Port Saint Lucie, FL, CCN 109028

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue83
Removal of skin lesions249
Removal of nail tissue1516
Removal or shaving of skin growth1091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P02624FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Podiatry, PA Foot & Ankle Surgery CurrentSince Jul 5, 2011 Accepting new patients
Indian River Primary Care PastSince Mar 9, 1998 Accepting new patients

Locations

1515 US Highway 1
Ste 204
Sebastian, FL 32958
Phone (772) 388-1161

1715 37th Pl
Fl 1
Vero Beach, FL 32960
Phone (772) 569-0081

1850 37th St
Ste 201
Vero Beach, FL 32960
Phone (772) 569-0081

1880 37th St
Ste 4
Vero Beach, FL 32960
Phone (772) 569-0081

Interoperability endpoints

  • Direct secure messaging: nrutledge@indianriver.mdlogic.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HECFAD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1669495172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329610099",
            "telephone_number": "772-569-0081",
            "fax_number": "772-569-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 37TH STREET, SUITE 4",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604502",
            "telephone_number": "772-569-0081",
            "fax_number": "772-569-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "NICHOLAS",
        "middle_name": "WARD",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "P02624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65519",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.