Samantha J Rutkoskie, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

90621 Issued in PA

Practice address

1245 S Cedar Crest Blvd Ste 301
Allentown, PA 18103-6258

Phone

(610) 402-9099

Fax

(610) 402-9029

NPI assigned

Jun 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennsylvania Anesthesia Coalition LLCGroup PAC ID 4284040189, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Pennsylvania Anesthesia Coalition LLC

  • Anesthesiology Physician
  • Sinking Spring, PA
  • NPI 1861091290

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Lehigh Valley Anesthesia Services, P. C.

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
  • NPI 1730174731

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1962763995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-9099",
            "fax_number": "610-402-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-9099",
            "fax_number": "610-402-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOSKIE",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN556259",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "90621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "50108906",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027809600001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND. BLUE CROSS",
            "identifier": "3881804000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "2707202",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12389010",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1608903",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "1962763995",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9761876",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "2707202",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela J Russo, LSW
• Orion Rust, MD
• Catherine Ruth
• Laura Rutherford
• Cheryl Rutkauskas
• Laure C Rutt, NP
• Veronica Rutt, DO
• Theresa Ryan-Mitlyng, MD
• Leigh Ann Ryan, LCSW
• Malika Ryan

• Certified Registered Nurse Anesthetist in Allentown, PA
• Providers in Allentown, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.