Active NPI
Joe Rusconi
- Physician Assistant
- Sacramento, CA
National Provider Identifier
1154824944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4800 Broadway Ste 100
Sacramento, CA 95820-1541 - Phone
- (916) 874-9623
- NPI assigned
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4800 Broadway Ste 100
Sacramento, CA 95820-1541
Mailing address
1161 Star Gazer LN
Placerville, CA 95667-9289
Phone (530) 622-1685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000-00-0000 | Other | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1154824944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1161 STAR GAZER LN",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956679289",
"telephone_number": "530-622-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 BROADWAY STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958201541",
"telephone_number": "916-874-9623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSCONI",
"first_name": "JOE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-17",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "0000-00-0000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.