Individual provider Active NPI

Rylie Russ, PA-C

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1013756352
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3290 W Big Beaver Rd Ste 150
Troy, MI 48084-2931
Phone
(248) 792-6257
Fax
(248) 792-9106
NPI assigned
May 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3290 W Big Beaver Rd Ste 150
Troy, MI 48084-2931

Mailing address

3290 W Big Beaver Rd Ste 150
Troy, MI 48084-2931
Phone (734) 536-5938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711000168 MI Practitioner - Physician Assistant 4082159389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Michigan Medical School, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jagannathan Neurosurgical Institute PLLCGroup PAC ID 9638317373, 11 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mt Pleasant, MI 48858-3257
Phone (989) 701-2538

2333 Progress St
West Branch, MI 48661-9384
Phone (989) 343-3178

Hospital & facility affiliations

  • McLaren Bay Region Hospital, Bay City, MI, CCN 230041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jagannathan Neurosurgical Institute PLLC CurrentSince Jul 1, 2024 Accepting new patients
Jagannathan Neurosurgical Institute PLLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

3290 W Big Beaver Rd
Ste 150
Troy, MI 48084
Phone (248) 792-6527

2333 Progress St
West Branch, MI 48661
Phone (989) 343-3178

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1013756352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 W BIG BEAVER RD STE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842931",
            "telephone_number": "734-536-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 W BIG BEAVER RD STE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842931",
            "telephone_number": "248-792-6257",
            "fax_number": "248-792-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "RYLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.