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Sandra Rustam , MA, LPCI

Counselor - Professional β€’ Beaverton, OR

Active NPI 1285820704 Individual Practitioner Female Practitioner
Practice location in NPPES

3601 Sw Murray Blvd, Suite 300
Beaverton, OR 970052354

Call 5037301790 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3601 Sw Murray Blvd
Suite 300

Beaverton, OR 970052354

Telephone 5037301790
Organization at the Same NPPES Address or Phone
Providence West Home Health Facility NPI 1659548782

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Beaverton and Oregon

100 active clinicians are listed under Counselor - Professional with a practice address in Beaverton, OR (2,559 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Beaverton

2% of these 100 clinicians have the CMS telehealth indicator.

13% of these 100 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Community/Behavioral Health

NUCC Taxonomy Code: 251S00000X

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Health Maintenance Organization

NUCC Taxonomy Code: 302R00000X

(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

Community Based Residential Treatment Facility, Mental Illness

NUCC Taxonomy Code: 320800000X

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Practice Location (Initial Record) November 25, 2016

Registered at 3601 SW MURRAY BLVD, SUITE 300, BEAVERTON, OR 970052354 (Tel: 5037301790)

πŸ“
Business Mailing Address (Initial Record) November 25, 2016

Registered at 14745 SW SANDHILL LOOP, SUITE 204, BEAVERTON, OR 970079079 (Tel: 5037301790)

πŸ‘€
Provider Name / Credentials (Initial Record) November 25, 2016

Recorded as SANDRA RUSTAM, M.A., LPCI

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 25, 2016

Counselor

πŸ”„
NPI Profile Reactivated November 17, 2016

Record officially reactivated for active practice on November 17, 2016

⚠️
NPI Profile Deactivated July 29, 2013

NPPES lists this NPI as deactivated as of July 29, 2013; the reason is not published.

🟒
Initial NPI Registration & Enumeration September 18, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1285820704
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 18, 2007
Last Update: November 25, 2016
Sole Proprietor: Yes

Mailing Address

14745 Sw Sandhill Loop, Suite 204

Beaverton, OR 970079079

Phone: 5037301790

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.