Dale R Rustad, MD in De Pere, WI - Medicare Pediatrics

Dale R Rustad, MD is a medicare enrolled "Pediatrics" physician in De Pere, Wisconsin. His current practice location is 3860 Monroe Rd, De Pere, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 496-4700.

Dale R Rustad is licensed to practice in Wisconsin (license number 35465) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1780617720.

Contact Information

	Dale R Rustad, MD
	3860 Monroe Rd, De Pere, WI 54115-8399
	(920) 496-4700
	(920) 431-1970

Map and Direction

Physician's Profile

Full Name	Dale R Rustad
Gender	Male
Speciality	Pediatrics
Location	3860 Monroe Rd, De Pere, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780617720
Provider Enumeration Date: 07/09/2006
Last Update Date: 08/13/2008

Medicare PECOS Information:

PECOS PAC ID: 2264516947
Enrollment ID: I20080220000449

Medical Identifiers

Medical identifiers for Dale R Rustad such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780617720	NPI	-	NPPES
32064000	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	35465 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dale R Rustad allows following entities to bill medicare on his behalf.

Entity Name	Prevea Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306869276 PECOS PAC ID: 0042123150 Enrollment ID: O20031106000034

Entity Name	St Vincent Hospital-hospital Sisters-third Order Of St Francis
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285613638 PECOS PAC ID: 5799694675 Enrollment ID: O20080620000423

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dale R Rustad is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dale R Rustad, MD Po Box 19070, Prevea Health, Green Bay, WI 54307-9070 Ph: (920) 496-4700	Dale R Rustad, MD 3860 Monroe Rd, De Pere, WI 54115-8399 Ph: (920) 496-4700

Reviews and Comments

Pediatrics Doctors in De Pere, WI

Dr. Rose M Cipres-jaucian, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1723 Spring Hills Ln, De Pere, WI 54115 Phone: 920-403-7982
Dr. Laura Jean Gallistel, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 555 Redbird Cir Ste 200, De Pere, WI 54115 Phone: 920-338-6820
Yoloxochitl Diaz, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1881 Chicago St, De Pere, WI 54115 Phone: 920-403-8000
Dr. Douglas Randal Zabrowski, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 555 Redbird Cir, De Pere, WI 54115 Phone: 920-969-5353 Fax: 414-337-7201
Matthew R. Theado, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 555 Redbird Cir, Suite 200, De Pere, WI 54115 Phone: 920-338-6820 Fax: 920-338-6829
Dr. Caitlin Quinn Barr, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 555 Redbird Cir, De Pere, WI 54115 Phone: 920-338-6820 Fax: 920-338-6829
Scott G Zahn, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1881 Chicago St, De Pere, WI 54115 Phone: 920-403-8000

Dale R Rustad, MD - Medicare Pediatrics in De Pere, WI