RUDOLPH B. RUSTIN III M.D.
NPI 1679548614
Surgery in Charlottesville, VA
About Rudolph B. Rustin Iii M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RUDOLPH B. RUSTIN III M.D. (NPI 1679548614) is an individual surgery provider in Charlottesville, Virginia, licensed in Virginia (0101258483) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 5
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rudolph B. Rustin Iii M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Rudolph Rustin reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Charlottesville, VA 22911
- Reassigned Medicare billing, Virginia enrollment
- 2,820 clinicians in this Medicare group
Dalton, GA 30720
- Reassigned Medicare billing, Georgia enrollment
- 236 clinicians in this Medicare group
Los Banos, CA 93635
- Reassigned Medicare billing, Georgia enrollment
- 16 clinicians in this Medicare group
Sacramento, CA 95816
- Reassigned Medicare billing, Georgia enrollment
- 37 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 22903 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
CHARLOTTESVILLE, VA 22903
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 Rudolph Rustin's NPI number?
The NPI number for Rudolph Rustin is 1679548614. It was assigned to this individual provider in the NPPES registry on February 22, 2006.
Where is Rudolph Rustin located?
Rudolph Rustin practices at 1300 Jefferson Park Ave 4th Floor, Charlottesville, VA 22903. The listed phone number is (434) 982-4411.
What is Rudolph Rustin's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Rudolph Rustin enrolled in Medicare?
Yes. Rudolph Rustin is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Rudolph Rustin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Rudolph Rustin reassigns Medicare benefits to 4 organizations: University Of Virginia Physicians Group (Charlottesville, VA), Hamilton Medical Center, Inc. (Dalton, GA), Surgical Affiliates Of California (Los Banos, CA) and Acute Care Surgery Medical Group, Inc. (Sacramento, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rudolph Rustin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Rudolph Rustin accept?
Health plans from Cigna Healthcare list Rudolph Rustin 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.
When was this NPI record last updated?
The NPPES record for Rudolph Rustin was last updated on September 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Rudolph B. Rustin III, M.D. · NPI 1679548614
Surgery physician in Charlottesville, Virginia. Individual provider, active in the CMS NPPES registry since February 22, 2006.
## Identity
- **NPI:** 1679548614 (Entity type: Individual)
- **Enumerated:** February 22, 2006
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 0101258483 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1300 JEFFERSON PARK AVE, 4TH FLOOR, Charlottesville, VA 22903-3363
- **Phone:** (434) 982-4411 · **Fax:** (434) 924-2260
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): University Of Virginia Physicians Group (NPI 1033138250, Charlottesville, VA); Hamilton Medical Center, Inc. (NPI 1528056066, Dalton, GA); Surgical Affiliates Of California (NPI 1932440781, Los Banos, CA); Acute Care Surgery Medical Group, Inc. (NPI 1700069549, Sacramento, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 9, 2016
- **Other identifiers:** Medicaid 1679548614 (VA); Medicare PIN E124756711 (SC); Medicare UPIN E12475 (SC); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1679548614) · Data from the CMS NPPES public registry.