Jack Rusley, MD
NPI 1639499395 · Pediatric Adolescent Medicine Physician · Providence, RI
Enrolled with Medicare as Practitioner - Pediatric Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jack Rusley, MD is a Pediatric Adolescent Medicine Physician provider in Providence, RI (NPI 1639499395).
Provider details
- NPI number
- 1639499395
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MD15912 (RI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 593 Eddy StProvidence, RI 02903-4923Phone: (401) 444-4712Fax: (401) 444-6220
Registry dates
- Enumerated
- 2010-06-04
- Last updated
- 2022-07-21
Frequently asked questions
- What is Jack Rusley's NPI number?
- Jack Rusley's National Provider Identifier (NPI) is 1639499395, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jack Rusley's specialty?
- Jack Rusley is listed in the NPPES registry with a primary specialty of Pediatric Adolescent Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Jack Rusley located?
- Jack Rusley's practice location on file with NPPES is 1 Hoppin St Ste 305, Providence, RI 02903-4141.
- What is Jack Rusley's phone number?
- The practice phone number listed in the NPPES registry for Jack Rusley is (401) 444-5980.
- Does Jack Rusley accept Medicare?
- Jack Rusley is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jack Rusley's NPI active?
- Yes — Jack Rusley's NPI (1639499395) is active in the NPPES registry as of the last update on 2022-07-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.