1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Nurse Practitioner
  6. NPI Profile

MARIVIC RUSTIA
NPI 1376012104
Nurse Practitioner - Acute Care in Portland, OR

Active since November 21, 2018PECOS EnrolledAccepts Medicare Assignment
86.03/100
CMS Quality Rating
2222 NW LOVEJOY ST STE 411, PORTLAND, OR 97210(503) 413-5598 Get Directions Write a Review

NPPES record last updated: October 12, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 12, 2021, Nov 21, 2018 (2 updates tracked since 2018).

About Marivic Rustia NPPES

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

MARIVIC RUSTIA (NPI 1376012104) is an individual acute care provider in Portland, Oregon, licensed in Texas (AP139794) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS, is affiliated with Legacy Good Samaritan Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1376012104
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMARIVIC RUSTIA
Location Address2222 NW LOVEJOY ST STE 411Portland, OR 97210-5102
Mailing Address255 Sw Harrison St Apt 11dPortland, OR 97201-5387 · (682) 240-5523
Phone(503) 413-5598
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 21, 2018
Last NPPES UpdateOctober 12, 20212 updates tracked since enumeration
NPPES CertifiedOctober 12, 2021
✔ NPI 1376012104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in TX · AP139794
2222 NW LOVEJOY ST STE 411, Portland, OR 97210
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marivic Rustia is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577897495
PECOS Enrollment IDI20210805002440
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
155 services142 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
46 services45 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
31 services30 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
15 services15 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380017
Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County
Emergency services Birthing friendly

Legacy Mount Hood Medical Center

Acute Care Hospitals · Gresham, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380025
Location24800 SE Stark StreetGresham, OR 97030 · Multnomah County
Emergency services Birthing friendly

Legacy Meridian Park Medical Center

Acute Care Hospitals · Tualatin, OR
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380089
Location19300 SW 65th AvenueTualatin, OR 97062 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97210 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.03/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.8
Promoting Interoperability99
Improvement Activities40
Cost74.15

Referred Medical Equipment & Supplies CMS DME claims 20

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
13 suppliers65 claims65 services$33.21 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
9 suppliers33 claims33 services$73.77 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
10 suppliers36 claims71 services$27.55 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers30 claims132 services$16.25 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
7 suppliers16 claims50 services$13.73 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
11 suppliers45 claims45 services$50.32 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

DR. CAROLINE MOTIKA M.D.
Internal Medicine (Pulmonary Disease)
2222 NW LOVEJOY ST STE 411
PORTLAND, OR 97210
Multnomah County (503) 413-5702
DR. STEVEN SEARS D.O.
Internal Medicine (Pulmonary Disease)
2222 NW LOVEJOY ST STE 411
PORTLAND, OR 97210
Multnomah County (503) 413-5702
MRS. DANIELLE DELL HOSMER MD
Internal Medicine (Pulmonary Disease)
2222 NW LOVEJOY ST STE 411
PORTLAND, OR 97210
Multnomah County (503) 413-5702
KAREN JOAN WESENBERG MD
Internal Medicine (Pulmonary Disease)
2222 NW LOVEJOY ST STE 411
PORTLAND, OR 97210
Multnomah County (503) 413-5702
MICHAEL CHOI PA
Physician Assistant
2222 NW LOVEJOY ST STE 411
PORTLAND, OR 97210
Multnomah County (503) 413-5702
MATTHEW CHAMPION M.D.
Internal Medicine (Pulmonary Disease)
2222 NW LOVEJOY ST STE 411
PORTLAND, OR 97210
Multnomah County (503) 413-5702

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 Marivic Rustia's NPI number?

The NPI number for Marivic Rustia is 1376012104. It was assigned to this individual provider in the NPPES registry on November 21, 2018.

Where is Marivic Rustia located?

Marivic Rustia practices at 2222 NW Lovejoy St Ste 411, Portland, OR 97210. The listed phone number is (503) 413-5598.

What is Marivic Rustia's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Marivic Rustia enrolled in Medicare?

Yes. Marivic Rustia is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Marivic Rustia accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Marivic Rustia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Marivic Rustia affiliated with any hospitals?

According to CMS data, Marivic Rustia is affiliated with Legacy Good Samaritan Medical Center, Legacy Mount Hood Medical Center and Legacy Meridian Park Medical Center.

When was this NPI record last updated?

The NPPES record for Marivic Rustia was last updated on October 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.