NPIMap

Individual provider Active NPI

Frederick D. Rutkovsky, M.D.

  • Gastroenterology Physician
  • Fresh Meadows, NY
National Provider Identifier
1477651123
Registry record updated May 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
176798 Issued in NY
Practice address
19303 Union Tpke
Fresh Meadows, NY 11366-1874
Phone
(718) 468-6600
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 176798 NY Primary

Addresses

Primary practice location

19303 Union Tpke
Fresh Meadows, NY 11366-1874

Mailing address

19303 Union Tpke
Fresh Meadows, NY 11366-1874
Phone (718) 468-6600

Other identifiers 1

IdentifierTypeStateIssuer
01723335MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081001000114 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 7012085210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
New York University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2248 31St St
Astoria, NY 11105-2714
Phone (718) 571-9192

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176798NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Health CurrentSince Apr 1, 2010 Accepting new patients
Medhat F Sami MD PC Current Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Aug 1, 2022 Accepting new patients
New York Internal Medicine, P.C. CurrentSince Sep 13, 2013 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Aug 1, 2022 Accepting new patients
LHHN Medical, P.C. Past Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

19303 Union Tpke
Fresh Meadows, NY 11366
Phone (516) 721-4648

1995 Nesconset Hwy
Lake Grove, NY 11755
Phone (631) 360-2273

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

2035 Lakeville Rd
North New Hyde Pk, NY 11040
Phone (516) 328-9797

1752 Francis Lewis Blvd
Whitestone, NY 11357
Phone (718) 746-9494

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: frederick.rutkovsky.1@2983.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241913600000",
    "number": "1477651123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19303 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661874",
            "telephone_number": "718-468-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19303 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661874",
            "telephone_number": "718-468-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOVSKY",
        "first_name": "FREDERICK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "176798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01723335",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.