Individual provider Active NPI

Kathryn Peck Rutenberg, M.D.

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1700887205
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
222999-1 Issued in NY
Practice address
4 West 58TH Street 9TH Floor
9TH Floor
New York, NY 10019
Phone
(929) 480-5400
Fax
(917) 261-2841
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 222999-1 NY Primary

Addresses

Primary practice location

4 West 58TH Street 9TH Floor
9TH Floor
New York, NY 10019

Mailing address

4 West 58TH Street 9TH Floor
9TH Floor
New York, NY 10019
Phone (929) 480-5400

Other identifiers 1

IdentifierTypeStateIssuer
02407014MedicaidNY

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
I20040816000969 NY Practitioner - Obstetrics/Gynecology 6406829753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Stony Brook, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222999-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2014 Accepting new patients
Icahn School of Medicine at Mount Sinai Obstetrics & Gynecology CurrentSince Sep 1, 2014 Accepting new patients
North Shore-Lij Medical PC Obstetrics & Gynecology CurrentSince Nov 25, 2020 Accepting new patients
St Lukes Roosevelt Community Care Obstetrics & Gynecology Past Accepting new patients
St Lukes Roosevelt Hospital Center Obstetrics & Gynecology Past Accepting new patients

Locations

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

200 W 57th St
New York, NY 10019
Phone (212) 247-8100

30 W 60th St
Apt 1S
New York, NY 10023
Phone (212) 459-2556

1000 10th Ave
Ste 10C
New York, NY 10019
Phone (212) 523-3452

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: krutenberg26485@northwell.direct-ci.com

Organizations & group practices 5

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 8

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1700887205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WEST 58TH STREET 9TH FLOOR",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "929-480-5400",
            "fax_number": "917-261-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WEST 58TH STREET 9TH FLOOR",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "929-480-5400",
            "fax_number": "917-261-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTENBERG",
        "first_name": "KATHRYN",
        "middle_name": "PECK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "222999-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02407014",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.