NPIMap

Individual provider Active NPI

Jared K Rustad, MD

  • Neurology Physician
  • Brainerd, MN
National Provider Identifier
1326195686
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
49604 Issued in MN
Practice address
2024 S 6TH St
Brainerd, MN 56401-3054
Phone
(218) 828-7100
Fax
(218) 828-7107
NPI assigned
Jan 5, 2007
Last updated
Jan 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 49604 MN Primary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 49604 MN

Addresses

Primary practice location

2024 S 6TH St
Brainerd, MN 56401-3054

Mailing address

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070808000244 MN Practitioner - Neurology 5698877991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of North Dakota School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brainerd Medical Center IncGroup PAC ID 0648270272, 29 clinicians
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 454-5935

2014 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 829-7812

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-2880

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7394

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49604MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brainerd Medical Center Inc CurrentSince Aug 13, 2007 Accepting new patients
St Joseph's Medical Center CurrentSince Aug 13, 2007 Accepting new patients
St. Joseph's Medical Center CurrentSince Aug 13, 2007 Accepting new patients
Brainerd Medical Center Inc. CurrentSince Aug 13, 2007 Accepting new patients
St. Joseph's Medical Center Past Accepting new patients
Brainerd Medical Center Inc Past Accepting new patients

Locations

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

Organizations & group practices 6

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 10

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1326195686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-829-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-828-7100",
            "fax_number": "218-828-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTAD",
        "first_name": "JARED",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "49604",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MN",
            "license": "49604",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.