Individual provider Active NPI

Jessica Lynn Rusciano

  • Women's Health Nurse Practitioner
  • Crystal, MN
National Provider Identifier
1235020355
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
13084 Issued in MN
Practice address
5109 36TH Ave N
Crystal, MN 55422-2007
Phone
(763) 587-7999
NPI assigned
Jul 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 13084 MN Primary
Registered Nurse 163W00000X 2491204 MN

Addresses

Primary practice location

5109 36TH Ave N
Crystal, MN 55422-2007

Mailing address

2713 Colorado Ave S
Minneapolis, MN 55416-1824
Phone (952) 451-1815

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.rusciano@nor.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250829002939 MN Practitioner - Nurse Practitioner 2961903075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Minnesota Medical School, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Clinic PAGroup PAC ID 2769384205, 50 clinicians

Practice addresses (Care Compare)

5109 36TH Ave N
Crystal, MN 55422-2007
Phone (763) 587-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2491204MNMDRegistered Nurse
13084MNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Clinic, PA CurrentSince Aug 1, 2025 Accepting new patients
North Clinic, PA CurrentSince Aug 1, 2025 Accepting new patients

Locations

9825 Hospital Dr
Ste 300
Maple Grove, MN 55369
Phone (763) 494-7500

5109 36th Ave N
Minneapolis, MN 55422
Phone (630) 632-2648

9201 W Broadway Ave
Ste 601
Minneapolis, MN 55445
Phone (763) 587-7933

50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625

Interoperability endpoints

  • Direct secure messaging: jessica.rusciano@nor.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1235020355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 COLORADO AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161824",
            "telephone_number": "952-451-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 36TH AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554222007",
            "telephone_number": "763-587-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSCIANO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "13084",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2491204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.rusciano@nor.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5109 36th Ave N",
            "city": "Crystal",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554222007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

Verify at the official NPI Registry.