Individual provider Active NPI

Anil K Rustgi, MD

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1609919588
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
299613 Issued in NY
Practice address
1130 Saint Nicholas Ave
New York, NY 10032-3802
Phone
(212) 851-4822
Fax
(212) 851-4660
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD066015L PA
Internal Medicine Physician 207R00000X 299613 NY
Gastroenterology Physician 207RG0100X MD066015L PA
Gastroenterology Physician 207RG0100X 299613 NY Primary

Addresses

Primary practice location

1130 Saint Nicholas Ave
New York, NY 10032-3802

Mailing address

1130 Saint Nicholas Ave RM 201
New York, NY 10032-3802
Phone (212) 851-4822

Other identifiers 1

IdentifierTypeStateIssuer
0017074250001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041029000381 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 3870555196 Reassigns benefits to 1 organization
I20191003001648 NY Practitioner - Gastroenterology 3870555196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
299613NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Gastroenterology CurrentSince Jul 24, 1998 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Aug 10, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Aug 10, 2019 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

1130 Saint Nicholas Ave
New York, NY 10032
Phone (212) 305-9335

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

1130 Saint Nicholas Ave
Rm 201
New York, NY 10032

161 Fort Washington Ave
#8
New York, NY 10032
Phone (646) 317-6041

3400 Spruce St
Fl 3
Philadelphia, PA 19104

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: anr9289@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1609919588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 SAINT NICHOLAS AVE RM 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323802",
            "telephone_number": "212-851-4822",
            "fax_number": "212-851-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323802",
            "telephone_number": "212-851-4822",
            "fax_number": "212-851-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTGI",
        "first_name": "ANIL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD066015L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "299613",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD066015L",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "299613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017074250001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.