Individual provider Active NPI

Jay J Rusek, MD

  • Surgery Physician
  • Stevens Point, WI
National Provider Identifier
1285761601
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33114 Issued in WI
Practice address
824 Illinois Avenue
Stevens Point, WI 54481
Phone
(715) 342-7500
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33114 WI Primary

Addresses

Primary practice location

824 Illinois Avenue
Stevens Point, WI 54481

Mailing address

900 Illinois Avenue
Stevens Point, WI 54481

Other identifiers 1

IdentifierTypeStateIssuer
31797800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33114WIMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1285761601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ILLINOIS AVENUE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 ILLINOIS AVENUE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-342-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSEK",
        "first_name": "JAY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "33114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31797800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.