| Douglas William Rusnack, MD | |
|
601 Front Avenue, Suite #502, Coeur D Alene, ID 83814 | |
| (208) 415-0524 | |
| (208) 763-3644 |
| Full Name | Douglas William Rusnack |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 27 Years |
| Location | 601 Front Avenue, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336101005 | NPI | - | NPPES |
| 010394856 | Medicaid | VA | |
| 2799048 | Other | PA | MEDICAL ASSISTANCE OH |
| 50017549 | Other | KY | PASSPORT |
| 1019685500001 | Other | PA | MEDICAL ASSISTANCE PA |
| 2799048 | Medicaid | OH | |
| 000000548198 | Other | KY | ANTHEM |
| 1019685500001 | Medicaid | PA | |
| 2501251 | Other | PA | MEDICAL ASSISTANCE NY |
| 3425603000 | Other | KY | PASSPORT ADVANTAGE |
| 7100025000 | Medicaid | KY | |
| 91732 | Other | KY | SIHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | M9059 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Saint Joseph Medical Ctr | Burbank, CA | Hospital |
| Ventura County Medical Center | Ventura, CA | Hospital |
| Glendale Mem Hospital & Hlth Center | Glendale, CA | Hospital |
| St Mary Medical Center | Long beach, CA | Hospital |
| Northridge Hospital Medical Center | Northridge, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Golden State Imaging Associates Inc | 1254761315 | 194 |
| Renaissance Imaging Medical Associates Inc | 7315841756 | 119 |
| Renaissance Imaging Medical Associates Inc | 7315841756 | 119 |
| Entity Name | Renaissance Imaging Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487608931 PECOS PAC ID: 7315841756 Enrollment ID: O20031126000257 |
| Entity Name | Silicon Valley Diagnostic Imaging Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629265806 PECOS PAC ID: 5496838518 Enrollment ID: O20080213000359 |
| Entity Name | Silicon Valley Medical Development Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164880761 PECOS PAC ID: 6103115183 Enrollment ID: O20160513001617 |
| Entity Name | Golden State Imaging Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144872052 PECOS PAC ID: 1254761315 Enrollment ID: O20200414001788 |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas William Rusnack, MD 601 Front Avenue, Suite #502, Coeur D Alene, ID 83814 Ph: (208) 415-0524 | Douglas William Rusnack, MD 601 Front Avenue, Suite #502, Coeur D Alene, ID 83814 Ph: (208) 415-0524 |
Dr. Brian Joseph Mcnamee, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814 Phone: 208-625-6300 Fax: 208-625-6301 | |
Dr. Michael Gerardo Melendez, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2789 E Spyglass Ct, Coeur D Alene, ID 83815 Phone: 208-610-0041 Fax: 208-777-1313 | |
Lauren Gayle Deur, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 250 Northwest Blvd, Suite #202, Coeur D Alene, ID 83814 Phone: 208-292-2263 Fax: 208-292-3130 | |
Dr. George F. Knight, M. D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 601 Front Avenue, Suite #502, Coeur D Alene, ID 83814 Phone: 208-415-0524 Fax: 208-763-3644 | |
Jeffrey Wayne Grossman, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2031 E Mountain Vista Dr, Coeur D Alene, ID 83815 Phone: 208-570-3342 | |
Dr. Patricia Ines Ojeda, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814 Phone: 208-625-6300 Fax: 208-625-6301 | |
Dr. Bryan Douglas Berkey, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814 Phone: 208-625-3000 Fax: 208-625-6301 |