Individual provider Active NPI

Bryce Russell-Anderson, PA-C

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1548759350
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1500 W Big Beaver Rd Ste 107
Troy, MI 48084-3522
Phone
(248) 689-1000
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1500 W Big Beaver Rd Ste 107
Troy, MI 48084-3522

Mailing address

2936 Thomas Ave
Berkley, MI 48072-1163
Phone (586) 256-0326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180710002564 MI Practitioner - Physician Assistant 4284980905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1548759350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 THOMAS AVE",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721163",
            "telephone_number": "586-256-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W BIG BEAVER RD STE 107",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843522",
            "telephone_number": "248-689-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL-ANDERSON",
        "first_name": "BRYCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.