Michael J Rutter, MPAS, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236

Phone

(210) 292-4242

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

Yes

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 TX

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1801952015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista RC Rokeh, MD, MS
• Jorge Romero Jr., DNP, APRN
• Colin James Rose, MD
• Natalie Marie Roy, PH.D.
• Emily E Rucker, PSYD
• Mark Daniel Ryan, D.D.S.
• Raphael John Quinones Sabado, DO
• Gerald W. Saboe, D.O., M.P.H.
• Rene Saenz, D.D.S.
• John A Safar, D.D.S.

• Surgical Physician Assistant in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.