Kennedy St. Clare Rutledge, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C5-0011805 Issued in DE

Practice address

2700 Silverside Rd Ste 2
Wilmington, DE 19810-3724

Phone

(302) 478-8421

NPI assigned

Sep 20, 2022

Last updated

Oct 5, 2024By the provider in NPPES

Sex

Female

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 DE

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

Merit-based Incentive Payment System (MIPS)

Final score

92.93 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

76.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Delaware Family Care Associates

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1639155625
  Medicare reassignment

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1831812387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SILVERSIDE RD STE 2",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198103724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SILVERSIDE RD STE 2",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198103724",
            "telephone_number": "302-478-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "KENNEDY",
        "middle_name": "ST. CLARE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas J. Russo, D.M.D
• Sofia Danielle Russo, DO
• Gale Helen Rutan, MD
• Jane Choung Rutledge, D.M.D.
• Jeffrey Francis Rutledge, DMD
• Ryan Resource Management LLC (Balanced Minds Behavioral Health)
• Jennie E. Ryan, APN
• Julia D. Ryan, MD
• Kathleen Ryan, MSNCPNP
• Kelly Ryan

• Physician Assistant in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; 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.