Scott Rustulka, MS, QASP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

11665 Avena PL
Ste 204
San Diego, CA 92128-2421

Phone

(760) 349-4200

Fax

(760) 349-4200

NPI assigned

Dec 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• The Play Cooperative

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  • Lawrenceville, GA
  • NPI 1689518128
  NPD Authorized official
• Jewel ABA Therapy

  • Behavior Analyst
  • Stockbridge, GA
  • NPI 1871356147
  NPD (past)
• Qillawasi LLC

  • Behavior Analyst
  • Tucker, GA
  • NPI 1467108035
  NPD (past)

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1992160618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11665 AVENA PL",
            "address_2": "STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282421",
            "telephone_number": "760-349-4200",
            "fax_number": "760-349-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 AVENA PL",
            "address_2": "STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282421",
            "telephone_number": "760-349-4200",
            "fax_number": "760-349-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTULKA",
        "first_name": "SCOTT",
        "credential": "MS, QASP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QASP",
            "identifier": "QASP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Russo
• Terri A. Russo, MD
• Ryan Anthony Rust, PA-C
• Derek Scott Rustich, DPT
• Stacy Rustico, M.D.
• Isabella Rusy
• Emily Ruth, AMFT
• Joseph Ruth, RN
• Annaliese Miriam Ruthberg
• Dawn Michelle Rutherford, MS, RDN

• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.