Individual provider Active NPI

Edward Victor Rutkovsky, MD

  • Internal Medicine Physician
  • New Hyde Park, NY
National Provider Identifier
1881603892
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1629141 Issued in NY
Practice address
2035 Lakeville Road
New Hyde Park, NY 11040
Phone
(516) 328-9797
Fax
(516) 352-6579
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1629141 NY Primary
Cardiovascular Disease Physician 207RC0000X 1629141 NY
In Vivo & In Vitro Nuclear Medicine Physician 207UN0903X 1629141 NY

Addresses

Primary practice location

2035 Lakeville Road
New Hyde Park, NY 11040

Mailing address

2035 Lakeville Road
New Hyde Park, NY 11040
Phone (516) 328-9797

Other identifiers 1

IdentifierTypeStateIssuer
01167399MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080222000499 NY Practitioner - Cardiovascular Disease (Cardiology) 3971687336

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2035 Lakeville Rd
New Hyde Park, NY 11040-1696

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1629141NYMDIn Vivo & In Vitro Nuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Summit Health Internal Medicine CurrentSince Mar 23, 1992 Accepting new patients
City Medical of Upper East Side, PLLC Past Accepting new patients

Locations

24818 Union Tpke
Bellerose, NY 11426
Phone (718) 300-3368

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

2035 Lakeville Rd
Ste 101
New Hyde Park, NY 11040
Phone (516) 328-2290

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

Networks

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

Interoperability endpoints

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1881603892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 LAKEVILLE ROAD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "516-328-9797",
            "fax_number": "516-352-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 LAKEVILLE ROAD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "516-328-9797",
            "fax_number": "516-352-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOVSKY",
        "first_name": "EDWARD",
        "middle_name": "VICTOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1629141",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "1629141",
            "primary": false
        },
        {
            "code": "207UN0903X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine",
            "state": "NY",
            "license": "1629141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01167399",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.