Individual provider Active NPI

Scott Thomas Rusin, MPT

  • Physical Therapist
  • Destin, FL
National Provider Identifier
1396868840
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23308 Issued in FL
Practice address
200 Calusa Blvd
Suite 300
Destin, FL 32541
Phone
(850) 460-2024
Fax
(850) 460-7987
NPI assigned
Apr 9, 2007
Last updated
Jul 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT23308 FL Primary

Addresses

Primary practice location

200 Calusa Blvd
Suite 300
Destin, FL 32541

Mailing address

200 Calusa Blvd
# 300
Destin, FL 32541-5753
Phone (803) 414-9880

Other identifiers 3

IdentifierTypeStateIssuer
Y906XOtherFLBCBSFL GRP #
735439OtherFLOPTUM HEALTH/UNITEDHEALTHCARE INDIVIDUAL
6923846OtherFLCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812007350 FL Practitioner - Physical Therapist in Private Practice 6507959046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 Calusa Blvd
Suite 300
Destin, FL 32541-5753
Phone (850) 460-2024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Iperformance Center Physical Therapist CurrentSince Mar 21, 2015 Accepting new patients
Evolve Therapy and Wellness PLLC Physical Therapist CurrentSince Jan 29, 2023 Accepting new patients

Locations

200 Calusa Blvd
Unit 300
Destin, FL 32541
Phone (850) 460-2024

209 S A St
Pensacola, FL 32502
Phone (850) 533-0266

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1396868840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CALUSA BLVD",
            "address_2": "# 300",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415753",
            "telephone_number": "803-414-9880",
            "fax_number": "850-460-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CALUSA BLVD",
            "address_2": "SUITE 300",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "32541",
            "telephone_number": "850-460-2024",
            "fax_number": "850-460-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSIN",
        "first_name": "SCOTT",
        "middle_name": "THOMAS",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL GRP #",
            "identifier": "Y906X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM HEALTH/UNITEDHEALTHCARE INDIVIDUAL",
            "identifier": "735439",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6923846",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.