DR. NICHOLAS J RUTKOWSKI (O.D.) – Optometrist, NPI 1730491655

DR. NICHOLAS J RUTKOWSKI (O.D.) is a healthcare provider. based in Bourbonnais, Illinois. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 046.010357 (IL). The NPI Number for DR. NICHOLAS J RUTKOWSKI (O.D.) is 1730491655

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICHOLAS J RUTKOWSKI (O.D.)
NPI
1730491655
Phone
(815) 217-9266
Address
870 N CONVENT ST
Enumeration Date
8 July 2010
Last Update Date
30 June 2021

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
8152179266
Graduation Year
2010 (16 years ago)
PAC ID
8729269923
Group Practice PAC ID
0345580056
Professional Enrollment ID
I20210901003610
Address ID
IL609141300BO870XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

Provider Addresses for DR. NICHOLAS J RUTKOWSKI (O.D.)

  • 870 N CONVENT ST

    BOURBONNAIS, IL 609141300

    Phone: (815) 217-9266

    Fax: (815) 301-3440

    Type: Location

  • 19975 S LAGRANGE RD

    FRANKFORT, IL 604233105

    Phone: (815) 464-5009

    Fax: (815) 464-3013

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $85.

Total Amount is formed as General ($85) + Research ($0) + Ownership ($0) = $85.

Last reported payment date: 2024-09-06 • Largest payer in this snapshot: CooperVision Inc. ($53).

Total Amount

$85

General + Research + Ownership

Payments

5

Total payment records

General Amount

$85

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-09-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210901003610IOptometryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
66984Removal of cataract with insertion of prosthetic lens3,02524$0
99203New patient office or other outpatient visit, 30-44 minutes2323$0
99213Established patient office or other outpatient visit, 20-29 minutes2120$0
View full utilization report →

Insurance plans in this area (ZIP 60914)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345580056View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

What number should I use to identify DR. NICHOLAS J RUTKOWSKI (O.D.) for billing?
Administrative and clinical systems typically use NPI 1730491655 for DR. NICHOLAS J RUTKOWSKI (O.D.).
Is DR. NICHOLAS J RUTKOWSKI (O.D.)'s NPI status active today?
Active status means DR. NICHOLAS J RUTKOWSKI (O.D.)'s NPI record is not deactivated in the public file.
What services align with DR. NICHOLAS J RUTKOWSKI (O.D.)'s listing?
DR. NICHOLAS J RUTKOWSKI (O.D.)'s public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
Can patients visit DR. NICHOLAS J RUTKOWSKI (O.D.) in Bourbonnais, Illinois?
For routing, start with Bourbonnais, Illinois for DR. NICHOLAS J RUTKOWSKI (O.D.), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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