Madina Rustamova, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11010473 Issued in FL

Practice address

3501 Johnson St
Hollywood, FL 33021-5421

Phone

(954) 987-2000

NPI assigned

May 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: madina.rustamova-herrera.1@18542.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18542/brand/1/csg/1/fhir/r4

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.

• Advanced Cardiovascular Consultants LLC

  • Cardiovascular Disease Physician
  • West Palm Beach, FL
  • NPI 1306329370
  Medicare reassignment NPD
• Swallowing Diagnostics Inc

  • Internal Medicine Physician
  • Parkland, FL
  • NPI 1710954672
  Medicare reassignment NPD

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1356925671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6093 NW 62ND TER",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330671538",
            "telephone_number": "954-578-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-987-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTAMOVA",
        "first_name": "MADINA",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Runco Therrien, M.D.
• Hattie Runzheimer
• Russell Elba D.C.P.a
• John Russin, M.D.
• Lala Rustamova
• Behruze Ruyani, MD
• RWW Home and Community Rehab Services Florida, LLC
• Rxperts Pharmacy Services, Inc.
• Helen V Rymaszewski, DSW LCSW
• Edouard Saade

• Family Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.