MEDICARE: JESSICA RUSBATCH PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	PS019043	PA
2	103T00000X	Psychologist	PS019043	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1E5823	OTHER	PA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659994671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RUSBATCH PSYD

Provider Business Mailing Address
First Line	:	1515 LOCUST ST STE 202
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 LOCUST ST STE 200
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5131
Country	:	US
Telephone Number	:	412-232-4301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2020
Last Update Date	:	06/08/2026

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Directions to “ JESSICA RUSBATCH PSYD” Practice Location

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