Michael R Ruffatto, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027467 Issued in IL

Practice address

1202 Harrington Dr
Champaign, IL 61821-6514

Phone

(217) 351-6388

NPI assigned

Jan 6, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1154651628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 WOODFIELD DR",
            "city": "SAVOY",
            "state": "IL",
            "postal_code": "618749504",
            "telephone_number": "217-356-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HARRINGTON DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618216514",
            "telephone_number": "217-351-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFATTO",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-06",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaun Michael Rudicil
• Kati Rudin
• Kristena Rudloff
• Kristin E Ruff
• Kara Marie Ruffatto, DMD
• Rafael Miguel Ruggieri, M.D.
• Kathleen G. Ruhter, P.T.
• Sarah Rumbley
• Kathryn Rumer
• Brooke Runge

• General Practice Dentistry in Champaign, IL
• Providers in Champaign, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.