Individual provider Active NPI

Peter Rudzinskiy, MD

  • Neurology Physician
  • West Monroe, LA
National Provider Identifier
1508081548
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA10689000 Issued in NJ
Practice address
503 McMillan Rd
West Monroe, LA 71291-5327
Phone
(512) 730-3056
Fax
(888) 730-1925
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 40856 CT
Neurology Physician 2084N0400X MD.207845 LA
Neurology Physician 2084N0400X 25MA10689000 NJ Primary

Addresses

Primary practice location

503 McMillan Rd
West Monroe, LA 71291-5327

Mailing address

11 Snowbird CT
West Windsor, NJ 08550-3251
Phone (860) 921-7670

Other practice location 1

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

Other practice location 2

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

Other practice location 3

2 Capital Way Ste 456
Pennington, NJ 08534-2521
Phone (609) 537-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address peter.rudzinskiy.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20190516001565 PA Practitioner - Neurology 9335240654 Reassigns benefits to 1 organization
I20200127001189 NJ Practitioner - Neurology 9335240654 Reassigns benefits to 2 organizations
Practice locations: Cherry Hill, NJ

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Multispecialty GroupGroup PAC ID 1850689894, 342 clinicians
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

2 Capital Way
Pennington, NJ 08534-2521
Phone (609) 537-7300

Hospital & facility affiliations

  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40856CTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Medical Group Neurology CurrentSince Jul 10, 2023 Accepting new patients
Capital Health Multispecialty Group Neurology CurrentSince Jul 10, 2023 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jun 1, 2019 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jun 1, 2019 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients

Locations

557 US Highway 130
East Windsor, NJ 08520
Phone (609) 303-4480

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

2 Capital Way
Ste 456
Pennington, NJ 08534
Phone (609) 537-7277

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2005 Technology Pkwy
Ste 400
Mechanicsburg, PA 17050

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1508081548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SNOWBIRD CT",
            "city": "WEST WINDSOR",
            "state": "NJ",
            "postal_code": "085503251",
            "telephone_number": "860-921-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 MCMILLAN RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915327",
            "telephone_number": "512-730-3056",
            "fax_number": "888-730-1925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "NJ",
            "postal_code": "08638",
            "country_code": "US",
            "telephone_number": "609-394-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Capital Way",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "08534",
            "country_code": "US",
            "telephone_number": "609-303-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Capital Way Ste 456",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "085342521",
            "country_code": "US",
            "telephone_number": "609-537-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDZINSKIY",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "40856",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "MD.207845",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA10689000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peter.rudzinskiy.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2 Capital Way Ste 456",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.