Organization Active NPI

Medpro Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Madison Heights, MI
National Provider Identifier
1093388159
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDPRO URGENT CARE PLLC
Practice address
31005 John R Rd Ste a
Madison Heights, MI 48071-1907
Phone
(248) 850-8306
Fax
(248) 808-6711
NPI assigned
Jul 19, 2021
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Joshua Ruedisueli, PANPI 1326425851
Title
Authorized Official
Phone
(248) 850-8306

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

31005 John R Rd Ste a
Madison Heights, MI 48071-1907

Mailing address

31005 John R Rd Ste a
Madison Heights, MI 48071-1907
Phone (248) 850-8306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210913001610 MI Part B Supplier - Clinic/Group Practice 9032515333 Receives reassigned benefits from 10 practitioners
Practice locations: Madison Heights, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2271277Medpro Urgent Care PLLC31005 John R Suite B, Madison Heights, MI 48071Certificate of waiverOct 30, 2026

National Provider Directory

National Provider Directory

Locations

31005 John R Rd
Ste A
Madison Heights, MI 48071
Phone (248) 850-8306

17901 Huron River Dr
Ste B
New Boston, MI 48164
Phone (734) 315-7072

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1093388159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31005 JOHN R RD STE A",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711907",
            "telephone_number": "248-850-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31005 JOHN R RD STE A",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711907",
            "telephone_number": "248-850-8306",
            "fax_number": "248-808-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPRO URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2023-09-06",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "RUEDISUELI",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "248-850-8306",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.