Individual provider Active NPI

Rustica A Bernardino, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1780694117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6881 Issued in NV
Practice address
901 Rancho LN
Las Vegas, NV 89106-3836
Phone
(702) 636-3000
Fax
(702) 636-3027
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6881 NV Primary

Addresses

Primary practice location

901 Rancho LN
Las Vegas, NV 89106-3836

Mailing address

PO Box 360001
North Las Vegas, NV 89036-8108
Phone (702) 636-3000

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wheaton Medical SC Family Medicine PastSince Nov 6, 2012 Accepting new patients
Illinois Back and Joint PLLC Family Medicine PastSince Jan 19, 2023 Accepting new patients
Countryside Medical SC Past Accepting new patients
Countryview Medical Center SC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780694117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360001",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890368108",
            "telephone_number": "702-636-3000",
            "fax_number": "702-636-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RANCHO LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063836",
            "telephone_number": "702-636-3000",
            "fax_number": "702-636-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARDINO",
        "first_name": "RUSTICA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "6881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.