Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Prevesh K Rustagi, MD

Individual provider Psychiatry Physician · NPI 1245237411

Dr. Prevesh K Rustagi, MD is a Psychiatry in Fort Wayne, Indiana. Qualified in 1978, 48 years ago. Works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
48
Licensed in
IN
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3400 E Coliseum Blvd Ste 340
Fort Wayne, IN 46805-1644
Phone: (260) 484-1312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1720 Beacon St, Fort Wayne, IN 46805-4749 — (260) 373-8000

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 01035370A (IN)

Record details

NPI number1245237411
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 3, 2005
Last updated in NPPESNovember 15, 2022
Certification dateNovember 15, 2022
Mailing address3400 E Coliseum Blvd, Suite 340, Fort Wayne, IN 46805-1644

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 1978 (48 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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