Jacob Joseph Rusk, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

57.253399 Issued in OH

Practice address

4235 Secor Rd
Toledo, OH 43623-4299

Phone

(419) 479-5831

Fax

(419) 479-5799

NPI assigned

Jun 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Family Practice

Education

University of Toledo College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Toledo Clinic Incorporated

  • Surgery Physician
  • Toledo, OH
  • NPI 1144217894

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Toledo Clinic Incorporated

  • Clinical Medical Laboratory
  • Toledo, OH
  • NPI 1114079167
  NPD
• Toledo Clinic Incorporated

  • Clinical Medical Laboratory
  • Maumee, OH
  • NPI 1275280125
  NPD
• Toledo Clinic Incorporated

  • Podiatrist
  • Sylvania, OH
  • NPI 1952097073
  NPD
• Toledo Clinic Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Oregon, OH
  • NPI 1518019587
  NPD (past)

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1700455474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-479-5831",
            "fax_number": "419-479-5799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 N Providence Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652034355",
            "country_code": "US",
            "telephone_number": "573-234-1070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSK",
        "first_name": "JACOB",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-17",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2021022587",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57.253399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0495256",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob L Rusch
• Jason M Rush
• Kellilyn Rush
• Kevin Douglas Rushing, CDCA
• Liandrin Rushing
• De Ante Russ
• John Albert Russ III, MD
• Antuanette Russell
• Benjamin Russell
• Corey B Russell, DPM

• Family Medicine Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.