Individual provider Active NPI

Margaret Ruyle Rukstalis, MD

  • Psychiatry Physician
  • Columbia, SC
National Provider Identifier
1649629619
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101275426 Issued in VA
Practice address
720 Gracern Rd Ste 120
Columbia, SC 29210-7657
Phone
(803) 296-8765
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 83178 SC
Addiction Psychiatry Physician 2084P0802X 83178 SC
Addiction Psychiatry Physician 2084P0802X 2016-00110 NC
Addiction Psychiatry Physician 2084P0802X MD057059L PA
Psychiatry Physician 2084P0800X 0101275426 VA Primary

Addresses

Primary practice location

720 Gracern Rd Ste 120
Columbia, SC 29210-7657

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

613 Surrey Path Trl
Winston Salem, NC 27104-5034
Phone (570) 412-4056

Other practice location 2

300 Palmetto Health Pkwy Ste 200
Columbia, SC 29212-1762
Phone (803) 434-4790

Other identifiers 1

IdentifierTypeStateIssuer
Q0011QMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 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
I20160926002008 NC Practitioner - Psychiatry 1254628860
I20220902002608 VA Practitioner - Psychiatry 1254628860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101275426VAMDPsychiatry Physician
2016-00110NCMDAddiction Psychiatry Physician
MD057059LPAMDAddiction Psychiatry Physician
83178SCMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Aug 15, 2022 Accepting new patients
Carilion Medical Center CurrentSince Aug 15, 2022 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Interoperability endpoints

  • Direct secure messaging: mrukstalis154116@direct.carilionclinic.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.

Hospital & facility affiliations 1

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1649629619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GRACERN RD STE 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107657",
            "telephone_number": "803-296-8765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 Surrey Path Trl",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271045034",
            "country_code": "US",
            "telephone_number": "570-412-4056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Palmetto Health Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292121762",
            "country_code": "US",
            "telephone_number": "803-434-4790",
            "fax_number": "803-434-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUKSTALIS",
        "first_name": "MARGARET",
        "middle_name": "RUYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "83178",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "SC",
            "license": "83178",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NC",
            "license": "2016-00110",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "PA",
            "license": "MD057059L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101275426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0011Q",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.