Nicholas J Rutkowski, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010357 Issued in IL

Practice address

870 N Convent St
Bourbonnais, IL 60914-1300

Phone

(815) 217-9266

Fax

(815) 301-3440

NPI assigned

Jul 8, 2010

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nicholas Rutkowski OD and Associates LLCGroup PAC ID 0345580056, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Nicholas Rutkowski, O.D. & Associates LLC

  • Optometrist
  • Bourbonnais, IL
  • NPI 1598150898
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1730491655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141300",
            "telephone_number": "815-217-9266",
            "fax_number": "815-301-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141300",
            "telephone_number": "815-217-9266",
            "fax_number": "815-301-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavez Rosenthal
• Rebecca Routson
• Amanda J Roy
• Nicole Roy, LPC
• Samantha Mary Ruhbeck, PA-C
• Bernard Eugene Ryan II, D.D.S.
• Kathleen M Saindon II
• Giovanni M Salerno, MD
• Chloe Ann Sanford
• Louis Dennis Santangelo, D.P.M.

• Optometrist in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.
• 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.