Individual provider Active NPI

Vanessa Ezabella Rusu, PA-C

  • Physician Assistant
  • Braselton, GA
National Provider Identifier
1699446963
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11498 Issued in GA
Practice address
1404 River PL Ste 501
Braselton, GA 30517-5600
Phone
(770) 212-3268
NPI assigned
Sep 25, 2021
Last updated
Jan 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11498 GA Primary

Addresses

Primary practice location

1404 River PL Ste 501
Braselton, GA 30517-5600

Mailing address

1404 River PL
Braselton, GA 30517-5600
Phone (770) 212-3268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526001117 GA Practitioner - Physician Assistant 5395102891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

1404 River PL
Suite 501
Braselton, GA 30517-5600
Phone (770) 534-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11498GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Heart Institute LLC CurrentSince Jan 1, 2026 Accepting new patients
Northeast Georgia Heart Center Current Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant PastSince Dec 21, 2025 Accepting new patients

Locations

1404 River Pl
Ste 501
Braselton, GA 30517
Phone (770) 212-3268

4445 S Lee St
Ste 200
Buford, GA 30518
Phone (770) 848-7160

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

Organizations & group practices 4

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.

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": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1699446963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 RIVER PL",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175600",
            "telephone_number": "770-212-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 RIVER PL STE 501",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175600",
            "telephone_number": "770-212-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSU",
        "first_name": "VANESSA",
        "middle_name": "EZABELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.