David Petrovich Rusev

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12804 Issued in NC

Practice address

920 Church St N
Concord, NC 28025-2927

Phone

(704) 403-3000

NPI assigned

Oct 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NC, WA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
• Capital Medical Center Hospital, Olympia, WA, CCN 500139
• Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Wake Forest Emergency Providers

  • Multi-Specialty Clinic/Center
  • Statesville, NC
  • NPI 1396216735
  Medicare reassignment Care Compare group
• Olympia Emergency Care Physicians PLLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1396498671
  Medicare reassignment NPD
• Einstein Practice Plan Inc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1770823791
  Medicare reassignment
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1073854766
  NPD
• Einstein Practice Plan Inc

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1801853288
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  • General Acute Care Hospital
  • Covington, WA
  • NPI 1326564071
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1841258639
  Care Compare affiliation

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1104468966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896244",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896244",
            "telephone_number": "866-282-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-7212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Old York Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413098",
            "country_code": "US",
            "telephone_number": "215-456-3834",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSEV",
        "first_name": "DAVID",
        "middle_name": "PETROVICH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MA06250",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia A Ruiz
• Lesley Fisher Rummage, NP
• Caitlin Stroud Runge, LCMHCA
• Christopher Jon Runge, PH.D.
• Nicole Fray Rup, MD
• Ambredawn Tacara Rush, AGPCNP
• Tamara Moser Rush, LCMHCA
• Lorraine Rushing, LPCA
• Emily Rusmisell, FNP-BC
• Adam Russell, PTA

• Physician Assistant in Concord, NC
• Providers in Concord, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.