Individual provider Active NPI

Ross D Rutkowski, D.C.

  • Chiropractor
  • Somerset, MA
National Provider Identifier
1942337639
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1804 Issued in MA
Practice address
1592 Grand Army Hwy
Somerset, MA 02726-1210
Phone
(508) 673-5400
Fax
(508) 673-6336
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1804 MA Primary

Addresses

Primary practice location

1592 Grand Army Hwy
Somerset, MA 02726-1210

Mailing address

1592 G.a.R. Hwy
Somerset, MA 02726-1210
Phone (508) 673-5400

Other identifiers 2

IdentifierTypeStateIssuer
043373981OtherMATAX IDENTIFICATION #
Y36286OtherMABLUE CROSS PROVIDER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140506000950 MA Practitioner - Chiropractic 0840423406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1592 Gar Hwy
Somerset, MA 02726-1210
Phone (508) 673-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1804MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rutkowski Family Chiropractic P.C. CurrentSince Oct 24, 2013 Accepting new patients

Locations

1592 Grand Army Hwy
Somerset, MA 02726
Phone (508) 673-5400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1942337639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1592 G.A.R. HWY",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027261210",
            "telephone_number": "508-673-5400",
            "fax_number": "508-673-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1592 GRAND ARMY HWY",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027261210",
            "telephone_number": "508-673-5400",
            "fax_number": "508-673-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "ROSS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION #",
            "identifier": "043373981",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER ID",
            "identifier": "Y36286",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.