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NPI Code Detail

MEDICARE: MATTHEW THOMAS DE RUYTER MD

MEDICARE: MATTHEW THOMAS DE RUYTER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0114XAdult Reconstructive Orthopaedic Surgery Physician04-51647KS
2207XS0114XAdult Reconstructive Orthopaedic Surgery PhysicianA194268CA

General Provider Information

NPI Number : 1396206868
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW THOMAS DE RUYTER MD
Provider Business Mailing Address
First Line : 4000 CAMBRIDGE ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8501
Country : US
Telephone Number : 913-588-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2060 W 39TH AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-2943
Country : US
Telephone Number : 913-588-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2019
Last Update Date : 05/11/2026

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