Individual provider Active NPI

Konstantin I Rusin, M.D.

  • Specialist
  • Detroit, MI
National Provider Identifier
1598706392
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301071917
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8521
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301071917 Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

744 W Michigan Ave
Jackson, MI 49201-1909
Phone (517) 787-6440

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520001059 MI Practitioner - Anesthesiology 1456342286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services Associates PCGroup PAC ID 4385557602, 67 clinicians

Practice addresses (Care Compare)

2775 Blake Rd
Jackson, MI 49201-8838
Phone (517) 787-2906

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Hospital & facility affiliations

  • McLaren Flint Hospital, Flint, MI, CCN 230141

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Associates, PC CurrentSince Jan 18, 2014 Accepting new patients

Locations

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

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 1

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1598706392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSIN",
        "first_name": "KONSTANTIN",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "4301071917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.