Douglas William Rusnack, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

M9059 Issued in ID

Practice address

601 Front Avenue
Suite #502
Coeur D Alene, ID 83814

Phone

(208) 415-0524

Fax

(208) 763-3644

NPI assigned

Apr 6, 2006

Last updated

May 27, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in CA, HI2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Columbia University College of Physicians and Surgeons, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Imaging Associates IncGroup PAC ID 1254761315, 242 clinicians

Silicon Valley Diagnostic Imaging IncGroup PAC ID 5496838518, 78 clinicians

City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Renaissance Imaging Medical Associates IncGroup PAC ID 7315841756, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Saint Joseph Medical Ctr Hospital, Burbank, CA, CCN 050235
• Ridgecrest Regional Hospital Hospital, Ridgecrest, CA, CCN 051333
• Ventura County Medical Center Hospital, Ventura, CA, CCN 050159
• Maui Memorial Medical Center Hospital, Wailuku, HI, CCN 120002
• Glendale Mem Hospital & HLTH Center Hospital, Glendale, CA, CCN 050058

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 51)

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.

• City of Hope Medical Foundation

  dba City of Hope Duarte

  • Hematology & Oncology Physician
  • Duarte, CA
  • NPI 1871886366
  Medicare reassignment Care Compare group NPD
• Golden State Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1144872052

  CA

  Medicare reassignment Care Compare group NPD
• Renaissance Imaging Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • Northridge, CA
  • NPI 1487608931

  HI

  Medicare reassignment Care Compare group NPD
• Silicon Valley Diagnostic Imaging, Inc.

  • Radiology Clinic/Center
  • Mountain View, CA
  • NPI 1629265806

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• El Camino Health Medical Network, LLC

  • Multi-Specialty Clinic/Center
  • San Jose, CA
  • NPI 1164880761
  Medicare reassignment NPD
• City of Hope Medical Foundation

  dba City of Hope Newport Beach

  • Hematology & Oncology Physician
  • Newport Beach, CA
  • NPI 1558930859
  NPD (past)
• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)
• New York University Medical Center Faculty Practice Radiology

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1114038353
  NPD (past)
• North Country Hospital & Health Center Inc

  dba Radiology Services North Country Hospital

  • Diagnostic Radiology Physician
  • Newport, VT
  • NPI 1124059035
  NPD (past)
• NYU Langone Hospitals

  dba NYU Langone Hospital - Suffolk

  • Psychiatric Hospital Unit
  • Patchogue, NY
  • NPI 1508687021
  NPD (past)
• Nyumc Radiology Associates

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1962513101
  NPD (past)
• Quantum Medical Radiology of California, P.C.

  • Diagnostic Radiology Physician
  • Palm Springs, CA
  • NPI 1558539130
  NPD (past)

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

• County of Ventura

  dba Ventura County Medical Center

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Care Compare affiliation
• Dignity Community Care

  dba Glendale Memorial Hospital and Health Center

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1477610640
  Care Compare affiliation
• Maui Health System a Kaiser Foundation Hospitals LLC

  dba Maui Memorial Medical Center

  • General Acute Care Hospital
  • Wailuku, HI
  • NPI 1013379460
  Care Compare affiliation
• Providence Health System - Southern California

  dba Providence Saint Joseph Medical Center

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  Care Compare affiliation
• Ridgecrest Regional Hospital

  • Critical Access Hospital
  • Ridgecrest, CA
  • NPI 1447253125
  Care Compare affiliation
• Ridgecrest Regional Hospital

  • Land Ambulance
  • Ridgecrest, CA
  • NPI 1699398560

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1336101005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 FRONT AVENUE",
            "address_2": "SUITE #502",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-415-0524",
            "fax_number": "208-763-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 FRONT AVENUE",
            "address_2": "SUITE #502",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-415-0524",
            "fax_number": "208-763-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSNACK",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M9059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000548198",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3425603000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100025000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "91732",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010394856",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019685500001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2799048",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE PA",
            "identifier": "1019685500001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE OH",
            "identifier": "2799048",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50017549",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE NY",
            "identifier": "2501251",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Rudd-Heilig
• Darcy Dee Ruffo, PMHNP-BC
• Angela Sarah Rummell, DPT
• Kristin Michele Rupinski, B.A., Q.P., C.M.
• Brooke T Rushton, CBRS
• Suzanne Jenkins Russell, LCSW CCM
• Alanna Caitlin Russo, NP
• Alison Lee Ruygrok, DPT
• Ryan Averett DPM PC
• Mary Whitney Ryan, PHD

• Diagnostic Radiology Physician in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.