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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

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 04, 2026.

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

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
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6124
ISRAEL SAUCEDO APRN, FNP-C
Nurse Practitioner (Acute Care)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-7050
JAVERIA NASEER MBBS
Student in an Organized Health Care Education/Training Program
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 382-7120
WILLIAM A GUEST MD
Internal Medicine (Pulmonary Disease)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-3400
JOSE ABANTAO PT
Physical Therapist
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-3347
DR. KAMRAN LATEEF MD
Internal Medicine
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6051
HEATH FARMER CRNA
Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 353-6124
DAVID RYAN ATKINS APRN-BC
Nurse Practitioner (Family)
901 18TH ST E
TIFTON, GA 31794
Tift County (229) 382-7120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Omar Al-rusan located?

Omar Al-rusan practices at 901 18th St E, Tifton, GA 31794. The listed phone number is (229) 382-7120.

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.

Is Omar Al-rusan enrolled in Medicare?

Yes. Omar Al-rusan is registered in the Medicare PECOS enrollment system.

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 22 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.