Active NPI
Ruth A Rustad, MD
- Dermatology Physician
- White Bear Lake, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 38316
- Practice address
- 4480 Centerville Rd
White Bear Lake, MN 55127-3674 - Phone
- (651) 484-2724
- Fax
- (651) 484-2723
- NPI assigned
- Apr 28, 2006
- Last updated
- Aug 1, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 38316 | MN | |
| Dermatology Physician | 207N00000X | 38316 | MN | Primary |
Addresses
Primary practice location
4480 Centerville Rd
White Bear Lake, MN 55127-3674
Mailing address
4480 Centerville Rd
White Bear Lake, MN 55127-3674
Phone (651) 484-2724
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110202652 | Other | MN | RR MEDICARE |
Other names 1
- Ruth A Anderson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Minnesota Medical School, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14130 60TH St N
Stillwater, MN 55082-6354
Phone (651) 484-2724
25 Lake St N
Suite 200
Forest Lake, MN 55025-2537
Phone (651) 430-2724
4480 Centerville Rd
White Bear Lake, MN 55127-3674
Phone (651) 484-2724
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.85 of 100
- Quality
- 70.56
- Promoting interoperability
- 81
- Improvement activities
- 40
- Cost
- 61.43
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 338 |
| Removal or shaving of skin growth | 39 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38316 | MN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Dermatology Care Medical Cosmetic and Surgery PA | Dermatology | Current | Accepting new patients |
| Advanced Dermatology Care Medical Cosmetic and Surgery PA | Dermatology | Current | Accepting new patients |
| Advanced Dermatology Care Medical Cosmetic and Surgery PA | Dermatology | Past | Accepting new patients |
Locations
25 Lake St N
Ste 200
Forest Lake, MN 55025
Phone (651) 430-2724
14130 60th St N
Stillwater, MN 55082
Phone (651) 484-2724
4480 Centerville Rd
White Bear Lk, MN 55127
Phone (612) 550-1152
Interoperability endpoints
- rrustad@adc.emadirect.md
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Advanced Dermatology Care
- Dermatology Physician
- White Bear Lake, MN
- NPI 1073614558
-
dba Advanced Dermatology Care
- Dermatology Physician
- Forest Lake, MN
- NPI 1912158031
-
dba Advanced Dermatology Care
- Dermatology Physician
- Stillwater, MN
- NPI 1144486978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343779200000",
"number": "1689631038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4480 CENTERVILLE RD",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551273674",
"telephone_number": "651-484-2724",
"fax_number": "651-484-2723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4480 CENTERVILLE RD",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551273674",
"telephone_number": "651-484-2724",
"fax_number": "651-484-2723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSTAD",
"first_name": "RUTH",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-28",
"last_updated": "2012-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "38316",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MN",
"license": "38316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110202652",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RUTH",
"last_name": "ANDERSON",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.