Individual provider Active NPI

Andrew Dylan Frutkin, M.D.

  • Interventional Cardiology Physician
  • Rancho Mirage, CA
National Provider Identifier
1407885403
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
C54394 Issued in CA
Practice address
39000 Bob Hope Dr
Hal B. Wallis BLDG.
Rancho Mirage, CA 92270-3221
Phone
(760) 346-0642
Fax
(760) 340-4874
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X C54394 CA Primary
Cardiovascular Disease Physician 207RC0000X C54394 CA
Interventional Cardiology Physician 207RI0011X MD28481 OR
Cardiovascular Disease Physician 207RC0000X MD28481 OR

Addresses

Primary practice location

39000 Bob Hope Dr
Hal B. Wallis BLDG.
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr
Hal B. Wallis BLDG.
Rancho Mirage, CA 92270-3221
Phone (760) 346-0642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105000413 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Peripheral Vascular Disease 2668450594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Peripheral Vascular Disease
Education
Stanford University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 773-2030

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573
  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting43
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54394CAMDDentist
C54394CAMDCardiovascular Disease Physician
MD28481ORMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Eisenhower Medical Center CurrentSince Nov 15, 2020 Accepting new patients
Saint Lukes Physician Group II LLC Past Accepting new patients
Peacehealth Medical Group Past Accepting new patients

Locations

39000 Bob Hope Dr
Ste 310
Rancho Mirage, CA 92270

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

39000 Bob Hope Dr
#B
Rancho Mirage, CA 92270
Phone (760) 346-0642

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

Interoperability endpoints

  • Direct secure messaging: afrutkin15353@edirect.emc.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1407885403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "HAL B. WALLIS BLDG.",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-0642",
            "fax_number": "760-340-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "HAL B. WALLIS BLDG.",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-0642",
            "fax_number": "760-340-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUTKIN",
        "first_name": "ANDREW",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "C54394",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C54394",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD28481",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD28481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.