Rudolph B. Rustin III, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0101258483 Issued in VA

Practice address

1300 Jefferson Park Ave
4TH Floor
Charlottesville, VA 22903-3363

Phone

(434) 982-4411

Fax

(434) 924-2260

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA, GA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rrustin19630@hhcs.direct-ci.com
• Direct secure messaging: rrustin719425@direct.memorialcare.org

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment NPD
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  Medicare reassignment NPD
• Surgical Affiliates of California

  • Surgery Physician
  • Los Banos, CA
  • NPI 1932440781

  GA

  Medicare reassignment NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549

  GA

  Medicare reassignment
• Hamilton Physician Group Inc

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1235455569
  NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Westminster,, CO
  • NPI 1477239267
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1679548614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON PARK AVE",
            "address_2": "4TH FLOOR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033363",
            "telephone_number": "434-982-4411",
            "fax_number": "434-924-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTIN",
        "first_name": "RUDOLPH",
        "middle_name": "B.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "14302",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "SC",
            "license": "14302",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101258483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679548614",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143026",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark A. Russell
• Nastassya Russell, FNP-C
• Ryan Pierce Russell
• Susanne Marie Russell, MSPT
• Daniel P Russo, MD
• Corina A Rusu, MD
• Ruth M Ball PHD LLC
• Laura Ruth, LCSW
• James T. Rutka, M.D.
• Chanel Rutledge, MD

• Surgery Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.