Active NPI
Michael Alan Ruzevich
- Pharmacist
- New Buffalo, MI
National Provider Identifier
1043835945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302038751
- Practice address
- 447 S Whittaker St
New Buffalo, MI 49117-1763 - Phone
- (844) 214-4446
- Fax
- (800) 430-2202
- NPI assigned
- Jun 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051031138 | IL | |
| Pharmacist | 183500000X | 26022851A | IN | |
| Pharmacist | 183500000X | 5302038751 | MI | Primary |
Addresses
Primary practice location
447 S Whittaker St
New Buffalo, MI 49117-1763
Mailing address
447 S Whittaker St
New Buffalo, MI 49117-1763
Phone (844) 214-4446
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051031138 | Other | IL | PHARMACIST LICENSE |
| 26022851A | Other | IN | REGISTERED PHARMACIST |
| 5302038751 | Other | MI | PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051031138 | IL | MD | Pharmacist |
| 26022851A | IN | MD | Pharmacist |
| 5302038751 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1043835945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 S WHITTAKER ST",
"city": "NEW BUFFALO",
"state": "MI",
"postal_code": "491171763",
"telephone_number": "844-214-4446",
"fax_number": "800-430-2202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "447 S WHITTAKER ST",
"city": "NEW BUFFALO",
"state": "MI",
"postal_code": "491171763",
"telephone_number": "844-214-4446",
"fax_number": "800-430-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUZEVICH",
"first_name": "MICHAEL",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-16",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051031138",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26022851A",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038751",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "051031138",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST",
"identifier": "26022851A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "5302038751",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Buffalo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.