Individual provider Active NPI

Erwin Rusli, MD

  • Trauma Surgery Physician
  • Bradenton, FL
National Provider Identifier
1396171641
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
130955 Issued in FL
Practice address
2010 59TH St W Ste 2200
Bradenton, FL 34209-4689
Phone
(941) 794-5621
Fax
(941) 761-1532
NPI assigned
Sep 18, 2013
Last updated
Apr 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 130955 FL Primary

Addresses

Primary practice location

2010 59TH St W Ste 2200
Bradenton, FL 34209-4689

Mailing address

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-6000

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170720002220 FL Practitioner - General Surgery 7113297318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Trauma Network, LLCGroup PAC ID 7911175658, 14 clinicians

Practice addresses (Care Compare)

2010 59TH St W
Suite 2200
Bradenton, FL 34209-4689
Phone (941) 794-5621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.62 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
76.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130955FLMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Trauma Network, LLC Trauma Surgery CurrentSince May 22, 2018 Accepting new patients

Locations

2010 59th St W
Bradenton, FL 34209
Phone (813) 453-0590

2010 59th St W
Ste 2200
Bradenton, FL 34209
Phone (941) 677-7220

14100 Fivay Rd
Ste 280
Hudson, FL 34667
Phone (727) 862-6524

6006 49th St N
Ste 310
St Petersburg, FL 33709
Phone (727) 345-2929

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: erwin.rusli@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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 3

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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1396171641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 59TH ST W STE 2200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094689",
            "telephone_number": "941-794-5621",
            "fax_number": "941-761-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSLI",
        "first_name": "ERWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-18",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "130955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.