Individual provider Active NPI

Jerome Michael Rutowski, FNP

  • Family Nurse Practitioner
  • Amherst, NY
National Provider Identifier
1780996769
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336414 Issued in NY
Practice address
4225 Maple Rd
Amherst, NY 14226-1039
Phone
(716) 834-0221
Fax
(781) 834-0222
NPI assigned
Jul 8, 2010
Last updated
Jul 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 336414 NY Primary

Addresses

Primary practice location

4225 Maple Rd
Amherst, NY 14226-1039

Mailing address

1440 Harlem Rd
Cheektowaga, NY 14206-1906
Phone (716) 894-2078

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000158 NY Practitioner - Nurse Practitioner 3971791567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

111 N Maplemere Rd
Suite 200
Williamsville, NY 14221-3182
Phone (716) 204-4532

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince May 20, 2024 Accepting new patients

Locations

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

3950 E Robinson Rd
Ste 305
West Amherst, NY 14228

111 N Maplemere Rd
Ste 200
Williamsville, NY 14221
Phone (716) 626-2644

Interoperability endpoints

  • Direct secure messaging: jrutowski@gppc.medentdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1780996769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 HARLEM RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142061906",
            "telephone_number": "716-894-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 MAPLE RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261039",
            "telephone_number": "716-834-0221",
            "fax_number": "781-834-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTOWSKI",
        "first_name": "JEROME",
        "middle_name": "MICHAEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.