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DALE R RUSTAD MD
NPI 1780617720
Pediatrics in De Pere, WI

Active since July 09, 2006PECOS Enrolled
3860 MONROE RD, DE PERE, WI 54115(920) 496-4700(920) 431-1970 Get Directions Write a Review

NPPES record last updated: August 13, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dale R Rustad Md NPPES

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

DALE R RUSTAD MD (NPI 1780617720) is an individual pediatrics provider in De Pere, Wisconsin, licensed in Wisconsin (35465) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780617720
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDALE R RUSTADCredential: MD
Location Address3860 MONROE RDDe Pere, WI 54115-8399
Mailing AddressPo Box 19070, Prevea HealthGreen Bay, WI 54307-9070 · (920) 496-4700 · Fax (920) 431-1970
Phone(920) 496-4700
Fax(920) 431-1970
Sole ProprietorNo
Enumeration DateJuly 9, 2006
Last NPPES UpdateAugust 13, 2008
✔ NPI 1780617720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WI · 35465
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3860 MONROE RD, De Pere, WI 54115
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Other Identifiers 3

Medicaid32064000WI
Medicare ID-Type Unspecified07125-0155
Medicare UPINF90126

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dale R Rustad Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 54115 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

CASSANDRA VANSTRATEN LPC
Counselor (Mental Health)
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
ROSALYN H HAASE RD CD
Dietitian, Registered
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
DANIELLE CASPER
Marriage & Family Therapist
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
MARIE D. IBARRA STAFFORD LPC
Counselor (Mental Health)
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
DR. JOSHUA VINCENT EGLE PT, DPT
Physical Therapist
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
MR. DAN J BRAATEN LMFT, SAC
Marriage & Family Therapist
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
STEPHANIE PREVOST M.S.
Counselor (Professional)
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700
ALEKSANDRA BABIARZ MD
Family Medicine
3860 MONROE RD
DE PERE, WI 54115
Brown County (920) 496-4700

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 Dale Rustad's NPI number?

The NPI number for Dale Rustad is 1780617720. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Dale Rustad located?

Dale Rustad practices at 3860 Monroe Rd, De Pere, WI 54115. The listed phone number is (920) 496-4700.

What is Dale Rustad's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Dale Rustad enrolled in Medicare?

Yes. Dale Rustad is registered in the Medicare PECOS enrollment system.

What insurance does Dale Rustad accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Dale Rustad 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 Dale Rustad was last updated on August 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.