Individual provider Active NPI

Andrew Ruczynski

  • Certified Registered Nurse Anesthetist
  • Richmond, MI
National Provider Identifier
1255217238
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704376184 Issued in MI
Practice address
70182 Arbor CT
Richmond, MI 48062-5732
Phone
(586) 524-0217
NPI assigned
Aug 14, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704376184 MI Primary

Addresses

Primary practice location

70182 Arbor CT
Richmond, MI 48062-5732

Mailing address

70182 Arbor CT
Richmond, MI 48062-5732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250918001541 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032613484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

3990 John R St
Detroit, MI 48201-2018
Phone (313) 993-0822

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704376184MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2025 Accepting new patients

Locations

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

Organizations & group practices 1

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 3

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": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1255217238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70182 ARBOR CT",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480625732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70182 ARBOR CT",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480625732",
            "telephone_number": "586-524-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCZYNSKI",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704376184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.