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

Jay T Rust Jr., PA

Individual provider Physician Assistant · NPI 1710185186

Jay T Rust Jr., PA is a Physician Assistant in New London, Wisconsin. Qualified in 2007, 19 years ago. Practices with Kaukauna Clinic, SC, an 8-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
19
Licensed in
WI
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1405 Mill St
New London, WI 54961-2155
Phone: (920) 531-2400
Fax: (920) 531-2463
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2162-023 (WI)

Record details

NPI number1710185186
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 6, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Kaukauna Clinic, S.C. — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in New London