Active NPI
Cindy Catherine Rullo
- Physician Assistant
- Moody Afb, GA
National Provider Identifier
1083315436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 3278 Mitchell Blvd
Moody Afb, GA 31699-1898 - Phone
- (229) 257-2778
- NPI assigned
- Mar 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3278 Mitchell Blvd
Moody Afb, GA 31699-1898
Mailing address
3278 Mitchell Blvd
Moody Afb, GA 31699-1898
Phone (229) 257-2778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
35 S Spruce St
Ramsey, NJ 07446-2549
Phone (201) 819-8545
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
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- Ramsey, NJ
- NPI 1285005884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725580800000",
"number": "1083315436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3278 MITCHELL BLVD",
"city": "MOODY AFB",
"state": "GA",
"postal_code": "316991898",
"telephone_number": "229-257-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3278 MITCHELL BLVD",
"city": "MOODY AFB",
"state": "GA",
"postal_code": "316991898",
"telephone_number": "229-257-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RULLO",
"first_name": "CINDY",
"middle_name": "CATHERINE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-13",
"last_updated": "2024-09-06",
"certification_date": "2024-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moody Afb, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.