Individual provider Active NPI

Kellie Jean Rusch, APRN, CNP

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1780297218
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6976 Issued in MN
Practice address
671 Vandalia St
Saint Paul, MN 55114-1312
Phone
(651) 698-2406
NPI assigned
Aug 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1747508 MN
Family Nurse Practitioner 363LF0000X 6976 MN Primary

Addresses

Primary practice location

671 Vandalia St
Saint Paul, MN 55114-1312

Mailing address

4227 Upton Ave N
Minneapolis, MN 55412-1523
Phone (612) 799-4660

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302000091 MN Practitioner - Nurse Practitioner 7618383563 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1747508MNMDRegistered Nurse
6976MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Nov 27, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Physicians CurrentSince Nov 27, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Nov 27, 2022 Accepting new patients
Fairview Express Care CurrentSince Nov 27, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
University of Minnesota Physicians CurrentSince Nov 27, 2022 Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Feb 22, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 4, 2022 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

303 E Nicollet Blvd
Ste 160
Burnsville, MN 55337
Phone (952) 460-4000

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

6525 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 848-8890

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Ste 202
Minneapolis, MN 55455
Phone (612) 273-8383

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

Interoperability endpoints

  • Direct secure messaging: krusch756487@fairview.direct-ci.com

Organizations & group practices 11

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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1780297218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 UPTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121523",
            "telephone_number": "612-799-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 VANDALIA ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141312",
            "telephone_number": "651-698-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSCH",
        "first_name": "KELLIE",
        "middle_name": "JEAN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1747508",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.