Dylan Rust

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

104 Haven Ave
New York, NY 10032-2654

Phone

(307) 871-7631

NPI assigned

Mar 8, 2022

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1407503626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W 148TH ST APT 59",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313112",
            "telephone_number": "307-871-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HAVEN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322654",
            "telephone_number": "307-871-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUST",
        "first_name": "DYLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djr2180@cumc.columbia.edu",
            "affiliation": "N",
            "address_1": "104 Haven Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100322654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Margarita Russolello, DACM, L.AC.
• Maria Russolello
• Russom Psychiatry, PLLC
• Rust Wellness LCSW PLLC
• David Rust, LCSW
• Maria N Rust, CPNP
• Kevin Rustam, PSY.D.
• Shahnoz Rustamova
• Anil K Rustgi, MD
• Sheila Rustgi

• Student in an Organized Health Care Education/Training Program in New York, NY
• Providers in New York, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.