Andrew Noah Prussack, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301118987 Issued in MI

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 205-4800

NPI assigned

Jun 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Andrew Prussack Former name

Electronic endpoints 1

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

Specialty

Anesthesiology

Education

Wayne State University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Novi Aas LLCGroup PAC ID 1557587847, 14 clinicians

Northwestern Services LLCGroup PAC ID 4486723657, 47 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.36 of 100Reported as group

Quality

81.36

Promoting interoperability

100

Improvement activities

40

Cost

74.56

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

85.92

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Northwestern Services, LLC

  • Certified Registered Nurse Anesthetist
  • Farmington Hills, MI
  • NPI 1215106679
  Medicare reassignment Care Compare group NPD
• Novi Aas LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1598176919
  Medicare reassignment Care Compare group NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• Northwestern Services, LLC

  • Anesthesiology Physician
  • Farmington Hills, MI
  • NPI 1083883649
  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667

  Anesthesiology

  NPD

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1629458559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSSACK",
        "first_name": "ANDREW",
        "middle_name": "NOAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301118987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aprussack197241@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREW",
            "last_name": "PRUSSACK",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Professional Consulting Services, LLC
• Prolific Family Chiropractic
• Cynthia Prough, NCMTB
• David Paul Prough, MD
• Farad Keith Pruitt, MD
• Julie Lynn Pryor, R.N./BSN
• Katharine Brickman Pryor, LMSW
• Joann D Przano, MA, LPC, LBSW
• Pulmonary Clinics of Southern Michigan
• Esther Pulver

• Anesthesiology Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.