Larisa Anatolievna Rusyn, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

IN PROGRESS Issued in NY

Practice address

462 1St Ave RM 8W52
New York, NY 10016-9196

Phone

(212) 562-6904

Fax

(212) 562-3273

NPI assigned

Aug 7, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Larisa Anatolievna Roussina Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

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.

• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975
  Medicare reassignment NPD
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD

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

{
    "created_epoch": "1312675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312675200000",
    "number": "1861771990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 1ST AVE RM 8W52",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-6904",
            "fax_number": "212-562-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE RM 8W52",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-6904",
            "fax_number": "212-562-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSYN",
        "first_name": "LARISA",
        "middle_name": "ANATOLIEVNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-07",
        "last_updated": "2011-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "IN PROGRESS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISA",
            "last_name": "ROUSSINA",
            "middle_name": "ANATOLIEVNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin Rustam, PSY.D.
• Shahnoz Rustamova
• Anil K Rustgi, MD
• Sheila Rustgi
• Judith Rustin, M.S.W.
• Kathryn Peck Rutenberg, M.D.
• Ruth H Weichsel MD PC
• Ruth Steinberg, MD, LLC
• Ruth Washton LCSW
• Abigail L Ruth, LCSW

• Pediatric Endocrinology Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatric Endocrinology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.