Individual provider Active NPI

Dawn Rutman, MS SPECIAL EDUCATION

  • Early Intervention Provider Agency
  • New York, NY
National Provider Identifier
1942637863
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
1614374 Issued in NY
Practice address
22 W. 15TH Street, #18D
New York, NY 10011
Phone
(917) 363-4129
NPI assigned
Oct 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1614374 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 1614374 NY
Early Intervention Provider Agency 252Y00000X 1614374 NY Primary

Addresses

Primary practice location

22 W. 15TH Street, #18D
New York, NY 10011

Mailing address

33 Manetto Dr
Plainview, NY 11803-2124
Phone (516) 576-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1614374NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1942637863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MANETTO DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118032124",
            "telephone_number": "516-576-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W. 15TH STREET, #18D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "917-363-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTMAN",
        "first_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MS SPECIAL EDUCATION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1614374",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "1614374",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "1614374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.