Individual provider Active NPI

Mary Rutnik-Pekins

  • Physical Therapist
  • Albany, NY
National Provider Identifier
1770986549
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010037 Issued in NY
Practice address
345 Northern Blvd
Suite 100
Albany, NY 12204-1001
Phone
(518) 462-1689
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010037 NY Primary

Addresses

Primary practice location

345 Northern Blvd
Suite 100
Albany, NY 12204-1001

Mailing address

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone (631) 467-3700

Other names 1

  • Mary Rutnik Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120000646 NY Practitioner - Physical Therapist in Private Practice 8325260722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

345 Northern Blvd
Albany, NY 12204-1001
Phone (518) 462-1689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Oct 1, 2014 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC Physical Therapist CurrentSince Oct 1, 2014 Accepting new patients

Locations

345 Northern Blvd
Ste 100
Albany, NY 12204
Phone (518) 462-1689

345 Northern Blvd
Albany, NY 12204
Phone (518) 462-1689

5 S Family Dr
Colonie, NY 12205
Phone (518) 213-9923

20 Peachtree Ct
Ste 105
Holbrook, NY 11741
Phone (518) 253-4983

2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058

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.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1770986549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NORTHERN BLVD",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041001",
            "telephone_number": "518-462-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTNIK-PEKINS",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "RUTNIK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.