Individual provider Active NPI

Michael Rus, M.D.

  • Anesthesiology Physician
  • Smithtown, NY
National Provider Identifier
1376528828
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
198185 Issued in NY
Practice address
7 Lorraine CT
Smithtown, NY 11787-1633
Phone
(631) 813-8216
Fax
(888) 939-3964
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 198185 NY Primary

Addresses

Primary practice location

7 Lorraine CT
Smithtown, NY 11787-1633

Mailing address

7 Lorraine CT
Smithtown, NY 11787-1633
Phone (631) 813-8216

Other identifiers 2

IdentifierTypeStateIssuer
CC0399OtherNYMEDICARE
02068257MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071113000614 NY Practitioner - Anesthesiology 4587752258 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great South Bay Endoscopy Center, LLC CurrentSince Oct 1, 2014 Accepting new patients
Office Based Anesthesia LLC Anesthesiology Past Accepting new patients
PPG Anesthesia, PLLC Anesthesiology Past Accepting new patients
Alliance Anesthesiology Associates, P.L.L.C. Anesthesiology Past Accepting new patients
Suffolk Anesthesiology Associates, PC Anesthesiology Past Accepting new patients
Physicians Choice Surgicenter Inc Past Accepting new patients
United Anesthesia PC Anesthesiology Past Accepting new patients

Locations

260 Patchogue Yaphank Rd
Ste C
East Patchogue, NY 11772
Phone (631) 289-0300

Organizations & group practices 7

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1376528828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LORRAINE CT",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871633",
            "telephone_number": "631-813-8216",
            "fax_number": "888-939-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LORRAINE CT",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871633",
            "telephone_number": "631-813-8216",
            "fax_number": "888-939-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "198185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CC0399",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02068257",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.