Organization Active NPI

Natick General Practice P C

  • Internal Medicine Physician
  • Natick, MA
National Provider Identifier
1689808677
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
159545 Issued in MA
Legal business name
NATICK GENERAL PRACTICE P C
Practice address
67 Union St
Suite 102
Natick, MA 01760-7700
Phone
(508) 650-7616
Fax
(508) 650-7814
NPI assigned
May 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Dr. Rentata C Ratusznik-Martin, M.D.
Title
General Partner
Phone
(508) 650-7615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 159545 MA Primary

Addresses

Primary practice location

67 Union St
Suite 102
Natick, MA 01760-7700

Mailing address

67 Union St
Suite 102
Natick, MA 01760-7700
Phone (508) 650-7616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090708000503 MA Part B Supplier - Clinic/Group Practice 2466504253 Receives reassigned benefits from 1 practitioner
Practice locations: Natick, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D1100703Natick General Practice67 Union Street Suite 303, Natick, MA 01760Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory

Locations

67 Union St
Ste 303
Natick, MA 01760

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1689808677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 UNION ST",
            "address_2": "SUITE 102",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017607700",
            "telephone_number": "508-650-7616",
            "fax_number": "508-650-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 UNION ST",
            "address_2": "SUITE 102",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017607700",
            "telephone_number": "508-650-7616",
            "fax_number": "508-650-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATICK GENERAL PRACTICE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "RATUSZNIK-MARTIN",
        "authorized_official_first_name": "RENTATA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "508-650-7615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "159545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.