Individual provider Active NPI

Kermit Russell Rust III, M.D.

  • Vascular & Interventional Radiology Physician
  • Wichita, KS
National Provider Identifier
1194036574
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
04-38788 Issued in KS
Practice address
9300 E 29TH St N Ste 206
Wichita, KS 67226-2183
Phone
(316) 260-6762
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125058810 IL
Diagnostic Radiology Physician 2085R0202X 28347 OK
Vascular & Interventional Radiology Physician 2085R0204X MD043000 DC
Vascular & Interventional Radiology Physician 2085R0204X 04-38788 KS Primary

Addresses

Primary practice location

9300 E 29TH St N Ste 206
Wichita, KS 67226-2183

Mailing address

9300 E 29TH St N Ste 206
Wichita, KS 67226-2183
Phone (316) 260-6762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20160607000262 KS Practitioner - Interventional RadiologyPractitioner - Diagnostic RadiologyPractitioner - Vascular Surgery 6709879554 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Vascular Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenwood County HospitalGroup PAC ID 0042129603, 31 clinicians
Hutchinson Regional Medical Center IncGroup PAC ID 0648181198, 145 clinicians
Hutchinson Clinic PA IncGroup PAC ID 5597658492, 130 clinicians
Southwest Medical CenterGroup PAC ID 7517941651, 62 clinicians
Wichita Radiological Group Prof AssocGroup PAC ID 6507762960, 26 clinicians

Practice addresses (Care Compare)

100 W 16TH St
Eureka, KS 67045-1064
Phone (620) 583-5274

1701 E 23Rd Ave
Hutchinson, KS 67502-1105

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

305 W 15TH St
Suite 102
Liberal, KS 67901-2455
Phone (620) 417-7577

551 N Hillside St
Suite 320
Wichita, KS 67214-4926
Phone (316) 685-1367

Hospital & facility affiliations

  • Wesley Medical Center Hospital, Wichita, KS, CCN 170123
  • William Newton Hospital Hospital, Winfield, KS, CCN 171383
  • Coffey County Hospital Hospital, Burlington, KS, CCN 171385
  • SCK Health Hospital, Arkansas City, KS, CCN 170779
  • Southwest Medical Center Hospital, Liberal, KS, CCN 170068

Merit-based Incentive Payment System (MIPS)

Final score
81.86 of 100Reported as group
Quality
97.21
Improvement activities
40
Cost
44.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125058810ILMDInternal Medicine Physician
28347OKMDDiagnostic Radiology Physician
MD043000DCMDVascular & Interventional Radiology Physician
17068CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Clinic, PA, Inc. CurrentSince Oct 13, 2025 Accepting new patients
Greenwood County Hospital CurrentSince Jul 1, 2025 Accepting new patients
Hutchinson Regional Medical Center, Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Premier Open MRI, Inc. Diagnostic Radiology CurrentSince Jun 1, 2016 Accepting new patients
Hutchinson Regional Medical Center, Inc. Family Medicine CurrentSince Sep 20, 2024 Accepting new patients
Wichita Radiological Group Prof Assoc CurrentSince Jul 1, 2016 Accepting new patients
Southwest Medical Center Diagnostic Radiology CurrentSince Jan 26, 2026 Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Internal Medicine CurrentSince Oct 13, 2025 Accepting new patients
Greenwood County Hospital CurrentSince Jul 1, 2025 Accepting new patients
Wesley Pathology Consultants PA Current Accepting new patients
Summit Surgical LLC Past Accepting new patients
Wichita Radiological Group Prof Assoc Past Accepting new patients

Locations

100 W 16th St
Eureka, KS 67045
Phone (620) 583-5274

1701 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 665-2117

2101 N Waldron St
Hutchinson, KS 67502
Phone (620) 669-2500

1818 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 662-6000

305 W 15th St
Ste 102
Liberal, KS 67901
Phone (620) 417-7577

619 S Clark Ave
Lyons, KS 67554
Phone (620) 257-5173

551 N Hillside St
Ste 320
Wichita, KS 67214
Phone (316) 962-2000

9300 E 29th St N
Ste 206
Wichita, KS 67226
Phone (316) 260-6762

500 S Main St
Wichita, KS 67202
Phone (316) 262-1103

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1194036574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N STE 206",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262183",
            "telephone_number": "316-260-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N STE 206",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262183",
            "telephone_number": "316-260-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUST",
        "first_name": "KERMIT",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125058810",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "28347",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "DC",
            "license": "MD043000",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KS",
            "license": "04-38788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.