Individual provider Active NPI

Magdalena M Rutkowski, MD

  • Family Medicine Physician
  • New Berlin, WI
National Provider Identifier
1487960019
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036133160 Issued in IL
Practice address
13900 W National Ave
New Berlin, WI 53151-9515
Phone
(262) 928-4500
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036133160 IL Primary
Family Medicine Physician 207Q00000X 65365 WI
Family Medicine Physician 207Q00000X MD226283 OR

Addresses

Primary practice location

13900 W National Ave
New Berlin, WI 53151-9515

Mailing address

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

Other practice location 1

390 9th St
Florence, OR 97439-9470
Phone (541) 997-7134

Other practice location 2

150 N River Rd Ste 110
Des Plaines, IL 60016-1272
Phone (847) 342-8956

Other practice location 3

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrutkowski20714@ce-direct.presencehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180503000126 IL Practitioner - Family Practice 2264665199 Reassigns benefits to 1 organization
I20250806003038 OR Practitioner - Family Practice 2264665199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Wound Care LLCGroup PAC ID 6507050770, 5 clinicians

Practice addresses (Care Compare)

1535 Lake Cook Rd
Suite 406
Northbrook, IL 60062-1453
Phone (847) 559-7702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036133160ILMDFamily Medicine Physician
MD226283ORMDFamily Medicine Physician
65365WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jul 23, 2025 Accepting new patients
Peacehealth Current Accepting new patients
Comprehensive Wound Care, LLC. CurrentSince Dec 7, 2025 Accepting new patients
Prohealth Medical Group Inc Family Medicine Past Accepting new patients

Locations

1535 Lake Cook Rd
Ste 406
Northbrook, IL 60062
Phone (847) 559-7702

400 9th St
Florence, OR 97439
Phone (541) 997-8412

390 9th St
Florence, OR 97439
Phone (541) 997-7134

Interoperability endpoints

  • Direct secure messaging: mrutkowski20714@ce-direct.presencehealth.org

Organizations & group practices 4

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 3

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1487960019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531519515",
            "telephone_number": "262-928-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 W NATIONAL AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531519515",
            "telephone_number": "262-928-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 9th St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974399470",
            "country_code": "US",
            "telephone_number": "541-997-7134",
            "fax_number": "541-902-7528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 N River Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600161272",
            "country_code": "US",
            "telephone_number": "847-342-8956",
            "fax_number": "847-342-8958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "MAGDALENA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036133160",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "65365",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD226283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrutkowski20714@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "150 N River Rd Ste 110",
            "city": "Des Plaines",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600161272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.