Charles Ruotolo (NPI# 1255307443, PAC ID# 9234118878) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1255307443 |
| PAC ID by PECOS | 9234118878 |
| Professional Enrollment ID | I20040716000423 |
| Full Name | Charles Ruotolo |
| Organization Legal Name | ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC |
| Address |
2103 Deer Park Ave Deer Park NY 11729-1319 |
| Phone Number | 8553216784 |
| Gender | M |
| Credential | MD |
| Medical School | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 1994 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 0648318063 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330027 | NASSAU UNIVERSITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2103 Deer Park Ave, Deer Park, NY 11729-1319 | 8553216784 | ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC |
| 2201 Hempstead Tpke, East Meadow, NY 11554-1859 | 5164866862 | NASSAU HEALTH CARE CORPORATION |
| 5500 Merrick Rd, Massapequa, NY 11758-6231 | 5167953033 | ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC |
| Physicians | 28 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michele White | Physician Assistant | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Lawrence Waxman | Physician Assistant | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Saverio A Cianciotta | Physician Assistant | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Rhyne C Dengenis | Orthopedic Surgery | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Michael F Trepeta | Orthopedic Surgery | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Carlos F Montero | Orthopedic Surgery | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Peter A Kechejian | Interventional Pain Management | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Abed Makkawi | Physician Assistant | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Richard A Mccormack | Orthopedic Surgery | Orthopaedics Spine and Sports Medicine LLC | 2201 Hempstead Tpke, Suite 668, East Meadow, NY 11554-1859 |
| Dante M Leven | Orthopedic Surgery | Orthopaedics Spine and Sports Medicine LLC | 5500 Merrick Rd, Massapequa, NY 11758-6231 |
| Street Address |
2103 DEER PARK AVE |
| City | DEER PARK |
| State | NY |
| Zip | 11729-1319 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana M Salgado | Physician Assistant | Mark Medical Care, Pllc | 2103 Deer Park Ave, Deer Park, NY 11729-1319 |
| Michael S Rosenhouse | Physical Therapy | 2103 Deer Park Ave, Deer Park, NY 11729-1317 | |
| Rocio A Romero | Physician Assistant | Mark Medical Care, Pllc | 2103 Deer Park Ave, Deer Park, NY 11729-1319 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Salvatore R Principe | Chiropractic | 420 Old Country Rd, Deer Park, NY 11729-1322 | |
| Paul P Tchao | Internal Medicine | 2043 Deer Park Ave, Deer Park, NY 11729-2110 | |
| Jack Nass | Psychiatry | 2100 Deer Park Ave, Suite 8, Deer Park, NY 11729-2119 | |
| Marta Teresa Silva | Psychologist, Clinical | 2100 Deer Park Ave, Suite 7, Deer Park, NY 11729-2119 | |
| Francine Dimaria | Family Medicine | 2090 Deer Park Ave, Deer Park, NY 11729-2129 | |
| Jeanine H Goldsmith | Clinical Social Worker | 2070 Deer Park Ave, Suite D, Deer Park, NY 11729-2134 | |
| Michael T Fitzgerald | Psychologist, Clinical | 2070 Deer Park Ave, Suite 2, Deer Park, NY 11729-2134 | |
| Joseph Dic | Family Medicine | 2005 Deer Park Ave, Suite D, Deer Park, NY 11729-2700 | |
| John L Braun | Physical Therapy | 2024 Deer Park Ave, Deer Park, NY 11729-2701 | |
| Sheela P De Oca | Physical Therapy | Island Musculoskeletal Care, M.d., P.C. | 1993 Deer Park Ave, Deer Park, NY 11729-2719 |
| Find all physicians in zip 11729 | |||
| City | DEER PARK |
| Zip Code | 11729 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | DEER PARK + ORTHOPEDIC SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.