Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Olivia Nicole Rutkowski, PA

Individual provider Physician Assistant · NPI 1104402163

MS. Olivia Nicole Rutkowski, PA is a Physician Assistant in Williamsville, New York. Qualified in 2020, 6 years ago. Practices with General Physician PC, a 487-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

10 Forestglen Cir
Williamsville, NY 14221-1359
Phone: (716) 697-2341
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104402163
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 21, 2021
Last updated in NPPESMarch 23, 2021
Certification dateMarch 23, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice General Physician Pc — 487 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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