Individual provider Active NPI

Jean Ann Klein Rusinak, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Hutchinson, MN
National Provider Identifier
1518084938
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
LP4939 Issued in MN
Practice address
1095 Highway 15 S
Hutchinson, MN 55350-5000
Phone
(320) 234-4610
Fax
(320) 234-4652
NPI assigned
Mar 22, 2007
Last updated
Oct 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X LP4939 MN Primary

Addresses

Primary practice location

1095 Highway 15 S
Hutchinson, MN 55350-5000

Mailing address

1095 Highway 15 S
Hutchinson, MN 55350-5000
Phone (320) 234-4610

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081001000100 MN Practitioner - Clinical Psychologist 2769550961 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Health CurrentSince Dec 21, 2009 Accepting new patients

Locations

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

1095 Highway 15 S
Hutchinson, MN 55350
Phone (320) 234-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1518084938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 HIGHWAY 15 S",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553505000",
            "telephone_number": "320-234-4610",
            "fax_number": "320-234-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 HIGHWAY 15 S",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553505000",
            "telephone_number": "320-234-4610",
            "fax_number": "320-234-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSINAK",
        "first_name": "JEAN",
        "middle_name": "ANN KLEIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP4939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutchinson, MN

Sources for this page

Verify at the official NPI Registry.