Ian Hunter Rutkofsky, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101275205 Issued in VA

Practice address

10701 Parkridge Blvd Ste 110
Reston, VA 20191-4423

Phone

(703) 880-4000

Fax

(703) 860-5760

NPI assigned

Apr 18, 2018

Last updated

Jun 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD, VA, PA4 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 4

Specialty

Psychiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psych Associates of Maryland LLCGroup PAC ID 3971550963, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Psych Associates of Maryland LLC

  dba Bloom Health Centers

  • Psychologist
  • Timonium, MD
  • NPI 1891721981

  DC, Psychiatry, VA

  Medicare reassignment Care Compare group NPD
• Altheda PC

  • Pediatrics Physician
  • McKees Rocks, PA
  • NPI 1699458042
  Medicare reassignment
• Amen Clinics, Inc DC

  • Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
  • Reston, VA
  • NPI 1124534607
  NPD (past)
• Neta, Inc.

  • Child & Adolescent Psychiatry Physician
  • Arlington, VA
  • NPI 1134506520
  NPD (past)

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1679060370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 PARKRIDGE BLVD STE 110",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914423",
            "telephone_number": "703-880-4000",
            "fax_number": "703-860-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 PARKRIDGE BLVD STE 110",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914423",
            "telephone_number": "703-880-4000",
            "fax_number": "703-860-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Hospital Drive",
            "address_2": "Building A, Suite 430",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31217",
            "country_code": "US",
            "telephone_number": "478-751-0367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTKOFSKY",
        "first_name": "IAN",
        "middle_name": "HUNTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME149460",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0094297",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.146287",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0025484",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD479594",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2022-02726",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101275205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Anthony Rulis, R.PH.
• Audrey M Rushin, M.D.
• Brandy M Russell, M.A., CCC-SLP
• Metkel B Russom, MSW
• Joseph Edward Rusz Jr., D.D.S.
• Leslie A Rye, D.D.S.
• S & D of Virginia Inc (Femme Care/Prosperity Internal Medicine Associates)
• Ilonka Sabic-Lukic, L.P.C.
• Brett Allen Sachse, MD
• Kathleen T Sachse, M.D.

• Psychiatry Physician in Reston, VA
• Providers in Reston, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.