NPIMap

Individual provider Active NPI

Amal Rustom, MD

  • Emergency Medicine Physician
  • Germantown, TN
National Provider Identifier
1831190834
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
27218 Issued in TN
Practice address
7691 Poplar Ave
Germantown, TN 38138-3904
Phone
(901) 516-6970
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 27218 TN Primary

Addresses

Primary practice location

7691 Poplar Ave
Germantown, TN 38138-3904

Mailing address

8010 Stage Hills Blvd
Bartlett, TN 38133-4032
Phone (901) 291-2400

Other identifiers 1

IdentifierTypeStateIssuer
3836613MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000851 TN Practitioner - Emergency Medicine 7416933411 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Germantown Emergency Physicians, PLLCGroup PAC ID 7214386812, 29 clinicians

Practice addresses (Care Compare)

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carr PLLC Emergency Medicine CurrentSince Sep 1, 2014 Accepting new patients
Methodist South Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Methodist North Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Germantown Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince May 10, 2020 Accepting new patients
Methodist University Emergency Physicians PLLC Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
C. Ferrell Varner MD, Inc. Emergency Medicine Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Francis J. Fenaughty MD, P.C. Emergency Medicine Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Locations

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1265 Union Ave
#8E
Memphis, TN 38104
Phone (901) 726-0999

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

Interoperability endpoints

  • Direct secure messaging: arustom22763@mlh.direct-ci.com

Organizations & group practices 11

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 3

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1831190834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 STAGE HILLS BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334032",
            "telephone_number": "901-291-2400",
            "fax_number": "901-379-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383904",
            "telephone_number": "901-516-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTOM",
        "first_name": "AMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "27218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3836613",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.