RUTH A RUSTAD (MD) – Dermatology Physician, NPI 1689631038

RUTH A RUSTAD (MD) is a healthcare provider. based in White bear lake, Minnesota. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 38316 (MN). The NPI Number for RUTH A RUSTAD (MD) is 1689631038

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
RUTH A RUSTAD (MD)
NPI
1689631038
Phone
(651) 484-2724
Address
4480 CENTERVILLE RD
Enumeration Date
28 April 2006
Last Update Date
1 August 2012

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
6514842724
Graduation Year
1994 (32 years ago)
PAC ID
0042201964
Group Practice PAC ID
4385633767
Professional Enrollment ID
I20040520000119
Address ID
MN551273674WH4480XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,636 INTERNAL MEDICINE in MN

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Provider Addresses for RUTH A RUSTAD (MD)

  • Centerville Rd, Centerville Road, White Bear Lake, White Bear Township, Ramsey County, Minnesota, 55127, United States

    WHITE BEAR LAKE, MN 551273674

    Phone: (651) 484-2724

    Fax: (651) 484-2723

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 30 Open Payments records for all available years, with a total value of $629.

Total Amount is formed as General ($629) + Research ($0) + Ownership ($0) = $629.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: REVANCE THERAPEUTICS, INC. ($169).

Total Amount

$629

General + Research + Ownership

Payments

30

Total payment records

General Amount

$629

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-05-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040520000119IInternal MedicineMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths24048$0
99214Established patient office or other outpatient visit, 30-39 minutes230140$0
G6001Ultrasonic guidance for placement of radiation therapy fields16624$0
77280Obtaining data needed to develop the optimal radiation treatment, 1 treatment area15823$0
77401Superficial and/or low voltage radiation treatment delivery15123$0
View full utilization report →

Insurance plans in this area (ZIP 55127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385633767View full group profile
NameSpecialtyState
D E R M A T O L O G YMN
Physician AssistantMN
Physician AssistantMN
Physician AssistantIL
Physician AssistantMN
Physician AssistantMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

What is the registry number for RUTH A RUSTAD (MD)?
The registry entry for RUTH A RUSTAD (MD) shows NPI 1689631038.
Is RUTH A RUSTAD (MD)'s NPI status active today?
Active status means RUTH A RUSTAD (MD)'s NPI record is not deactivated in the public file.
What type of care does RUTH A RUSTAD (MD) provide?
RUTH A RUSTAD (MD)'s profile centers on Dermatology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to RUTH A RUSTAD (MD)?
RUTH A RUSTAD (MD) is associated with White Bear Lake, Minnesota in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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