Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Al-Kharusy, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1043876659

Jacob Al-Kharusy, MD is an Anesthesiology in Grand Rapids, Michigan. Graduated from Michigan State University College of Human Medicine in 2019, 7 years ago. Practices with Saint Mary's Health Services, a 177-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Trained at
Michigan State University College of Human Medicine
Licensed in
MI
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone: (616) 685-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 4301509113 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1043876659
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 20, 2019
Last updated in NPPESJanuary 26, 2024
Certification dateJanuary 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated 2019 (7 years in practice)
Group practice Saint Mary'S Health Services — 177 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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