Phillip Brent Reustle, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3367 Issued in SC

Practice address

225 E Wood St
Spartanburg, SC 29303-3050

Phone

(864) 560-4420

NPI assigned

Sep 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

MCPC-10 LLCGroup PAC ID 8224289772, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: preustle127244@firsthealth.direct-ci.net
• Direct secure messaging: preustle538093@selfregional.direct-ci.net

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.

• MCPC-10, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Pinehurst, NC
  • NPI 1457600504
  Medicare reassignment Care Compare group NPD
• Spartanburg Medical Center

  • Emergency Medicine Physician
  • Spartanburg, SC
  • NPI 1699729939
  Medicare reassignment Care Compare group
• Grand Strand Surgical Specialists, LLC

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1841465804
  Medicare reassignment
• Piedmont Physician Network LLC

  • Internal Medicine Physician
  • York, SC
  • NPI 1194277186
  Medicare reassignment
• Spartanburg Medical Center

  • Cardiovascular Disease Physician
  • Spartanburg, SC
  • NPI 1013781400
  NPD
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Geoffrey R. Cousins, MD, PLLC

  • Specialist
  • Charleston, WV
  • NPI 1093988545
  NPD (past)
• Nestor F Dans MD PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charleston, WV
  • NPI 1386734051
  NPD (past)
• Teays Valley Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Hurricane, WV
  • NPI 1386760502

  Physician Assistant

  NPD (past)

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

• Spartanburg Medical Center

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1033681630
  Care Compare affiliation
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697

  Hospital

  Care Compare affiliation
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  Care Compare affiliation
• Spartanburg Medical Center

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
  • NPI 1942772546
  Care Compare affiliation

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

{
    "created_epoch": "1189814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1356537161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033050",
            "telephone_number": "864-560-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Piedmont Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321825",
            "country_code": "US",
            "telephone_number": "803-324-1950",
            "fax_number": "803-324-1933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REUSTLE",
        "first_name": "PHILLIP",
        "middle_name": "BRENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-15",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3367",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "3367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCG4005019",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3359PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preustle187367@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "preustle187367@direct-srhs.et0939.epichosted.com",
            "address_1": "225 E Wood St",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Renaissance Therapy & Forensic Counseling Center
• Alison Markley Renner, DO
• James Norman Rentz Sr., LMFT
• Kaitlin Elizabeth Resch, MS, ATC, LAT
• Kimberly Lynnette Restrepo
• Meredith Revan, RN
• Griffin Revell, DMD
• Annie Dahena Rexha
• Gabriella Reyes, MD
• Jessica Leigh Reynolds, M.D.

• Surgical Physician Assistant in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Surgical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.