Individual provider Active NPI

Tara Marie Rukstalis, N.P.

  • Acute Care Nurse Practitioner
  • Boston, MA
National Provider Identifier
1255566279
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN2259257 Issued in MA
Practice address
110 Francis St Ste 3B
Boston, MA 02215-5501
Phone
(617) 632-7246
Fax
(617) 632-0949
NPI assigned
May 19, 2009
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2259257 MA Primary
Audiologist 231H00000X 826 MA

Addresses

Primary practice location

110 Francis St Ste 3B
Boston, MA 02215-5501

Mailing address

110 Francis St Ste 3B
Boston, MA 02215-5501
Phone (617) 632-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110506000467 MA Practitioner - Nurse Practitioner 6901081967 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321

110 Francis St
Boston, MA 02215-5501
Phone (617) 632-7246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
826MAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce CurrentSince Jul 16, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2021 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 16, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 16, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 16, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients
Medical Care of Boston Management Corporation Past Accepting new patients
Beith Isreal Deaconess Medical Center PastSince Nov 21, 2021 Accepting new patients

Locations

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

110 Francis St
Boston, MA 02215
Phone (617) 632-7246

110 Francis St
Ste 3B
Boston, MA 02215
Phone (617) 632-7246

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Interoperability endpoints

  • Direct secure messaging: trukstalis254612@direct.bilh.masshiway.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1255566279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE 3B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-7246",
            "fax_number": "617-632-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE 3B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-7246",
            "fax_number": "617-632-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUKSTALIS",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2259257",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.