Individual provider Active NPI

Susan Lauren Rusnack, M.D.

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1790957504
Registry record updated Aug 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C128392 Issued in CA
Practice address
8631 W 3Rd St
Suite 715E
Los Angeles, CA 90048-5901
Phone
(310) 278-8330
Fax
(310) 278-7595
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 236481 NY
Urology Physician 208800000X C128392 CA Primary

Addresses

Primary practice location

8631 W 3Rd St
Suite 715E
Los Angeles, CA 90048-5901

Mailing address

8631 W 3Rd St
Suite 715E
Los Angeles, CA 90048-5901
Phone (310) 278-8330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140711002245 CA Practitioner - Urology 5395803779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Jefferson Medical College of Thomas Jefferson University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tower Urology IncGroup PAC ID 7315918885, 13 clinicians

Practice addresses (Care Compare)

8635 W 3Rd St
Suite 1W
Los Angeles, CA 90048-6102
Phone 3108549898159

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C128392CAMDUrology Physician
236481NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Urology Medical Group CurrentSince Apr 15, 2014 Accepting new patients
Uci Department of Urology Urology Past Accepting new patients

Locations

8631 W 3rd St
Ste 1115E
Los Angeles, CA 90048
Phone (310) 278-8330

8631 W 3rd St
Ste 715E
Los Angeles, CA 90048
Phone (310) 278-8330

Interoperability endpoints

  • Direct secure messaging: susan.rusnak@towerurology.directbygreenway.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408233600000",
    "number": "1790957504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 715E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-278-8330",
            "fax_number": "310-278-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 715E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-278-8330",
            "fax_number": "310-278-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSNACK",
        "first_name": "SUSAN",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2014-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "236481",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C128392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.