Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

OMAR AL-RUSAN MD
NPI 1205409398
Pathology - Anatomic Pathology & Clinical Pathology in Tifton, GA

Q: What is Omar Al-rusan's NPI number?

The NPI number for Omar Al-rusan is 1205409398. It was assigned to this individual provider in the NPPES registry on July 19, 2021.

Q: What is Omar Al-rusan's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Q: When was this NPI record last updated?

The NPPES record for Omar Al-rusan was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 19, 2021PECOS Enrolled

901 18TH ST E, TIFTON, GA 31794(229) 382-7120(229) 353-7779 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 17, 2026, Jul 19, 2021 (2 updates tracked since 2021).

On this page

About Omar Al-rusan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMAR AL-RUSAN MD (NPI 1205409398) is an individual anatomic pathology & clinical pathology provider in Tifton, Georgia, licensed in Georgia (13345) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1205409398

Entity TypeIndividualMale

Primary Taxonomy207ZP0102X

Provider Legal NameOMAR AL-RUSANCredential: MD

Location Address901 18TH ST ETifton, GA 31794-3648

Mailing AddressPo Box 2650Tifton, GA 31793-2650 · (229) 402-0425 · Fax (229) 391-4059

Phone(229) 382-7120

Fax(229) 353-7779

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJuly 19, 2021

Last NPPES UpdateSeptember 17, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2026

✔ NPI 1205409398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

License✔ Licensed in GA · 13345

Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

901 18TH ST E, Tifton, GA 31794

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Omar Al-rusan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810452612

PECOS Enrollment IDI20260722002712

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Omar Al-rusan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tift Regional Health System Inc.

Same address

General Acute Care Hospital

901 18TH ST E
Tifton, GA 31794

Reassigned Medicare billing, Georgia enrollment
380 clinicians in this Medicare group

NPI 1962462226 (229) 382-7120

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COLE BURGESS CRNA

Nurse Anesthetist, Certified Registered