Individual provider Active NPI

Rebecca Hruska, CSFA

  • Surgical Physician Assistant
  • Saint Louis, MO
National Provider Identifier
1780193300
Registry record updated Oct 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
165787 Issued in TN
Practice address
615 S Ballas Rd
Saint Louis, MO 63122-5314
Phone
(618) 616-1658
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 165787 TN Primary

Addresses

Primary practice location

615 S Ballas Rd
Saint Louis, MO 63122-5314

Mailing address

1503 Buckhurst CT
Ballwin, MO 63021-8395
Phone (618) 616-1658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
165787TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Surgical Consultants, LLC Surgical CurrentSince Oct 17, 2021 Accepting new patients

Organizations & group practices 1

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1780193300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 BUCKHURST CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630218395",
            "telephone_number": "618-616-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631225314",
            "telephone_number": "618-616-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRUSKA",
        "first_name": "REBECCA",
        "credential": "CSFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "165787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.