NPIMap

Melissa L Rust, PA-C

Individual provider Active NPI Physician Assistant · Worcester, MA

NPI 1477528412 · NPPES record last updated Nov 17, 2014

Key facts

NPI
1477528412
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA1700 (MA)
Practice address
55 Lake Ave N
Pediatrics
Worcester, MA 01655-0002
Phone
(774) 442-2853
Fax
(774) 443-7042
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1700MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Child Health Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mrust13935@direct.chppoc.masshiway.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1700 MA Yes

Addresses

Primary practice location

55 Lake Ave N
Pediatrics
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-0001
Phone (800) 225-8885

Other names

  • Melissa Marion Former name

Other providers in Worcester, MA

All providers in Worcester, MA · Physician Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.