Individual provider Active NPI

Matthew James Rustici, M.D.

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1619140167
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR0049756 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4507
Phone
(303) 602-5151
NPI assigned
Apr 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR0049756 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4507

Mailing address

4200 E 9TH Ave
Denver, CO 80262-0001
Phone (303) 315-7424

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrustici11185@direct.dhha.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20110622000559 CO Practitioner - Pediatric Medicine 6204014244 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0049756COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Apr 1, 2011 Accepting new patients
Denver Health and Hospital Authority CurrentSince Apr 1, 2011 Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: mrustici11185@direct.dhha.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1619140167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 E 9TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802620001",
            "telephone_number": "303-315-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-602-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTICI",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR0049756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrustici11185@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.