Holly Nicole Ruby, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101026243 Issued in MI

Practice address

32100 Telegraph Rd Ste 110
Bingham Farms, MI 48025-2408

Phone

(248) 644-1221

Fax

(248) 644-2748

NPI assigned

Jun 18, 2018

Last updated

May 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beverly Hills Pediatrics, PC

  • Pediatrics Physician
  • Bingham Farms, MI
  • NPI 1437100013
  NPD (past)
• Partnership of Pediatricians & Mentors, Inc.

  • Specialist
  • Bingham Farms, MI
  • NPI 1477744837
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1063906667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD STE 110",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252408",
            "telephone_number": "248-644-1221",
            "fax_number": "248-644-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD STE 110",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252408",
            "telephone_number": "248-644-1221",
            "fax_number": "248-644-2748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Metro Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483104102",
            "country_code": "US",
            "telephone_number": "586-268-7110",
            "fax_number": "586-268-2774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBY",
        "first_name": "HOLLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026243",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101023836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Daniela Rozo
• RRD Acquisition, LLC (Images International)
• Lainey Starr Rubin-Safran, BCBA
• Eugene Rubin, M.D.
• Kevin Rubin
• Mary M Ruch
• Theresa M Rudnik Jr.
• Stacey Lynn Rudy, PA-C
• Breeona Rue
• Angeles Ruiz Alvarado

• Pediatrics Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.