NPIMap

Individual provider Active NPI

Stacey Marie Ruff, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Berkley, MI
National Provider Identifier
1184941841
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
5101018589 Issued in MI
Practice address
1949 W 12 Mile Rd
#100
Berkley, MI 48072-1868
Phone
(248) 551-1756
Fax
(248) 551-9566
NPI assigned
Apr 21, 2010
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101018589 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 5101018589 MI Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 5101018589 MI

Addresses

Primary practice location

1949 W 12 Mile Rd
#100
Berkley, MI 48072-1868

Mailing address

1949 W 12 Mile Rd
#100
Berkley, MI 48072-1868
Phone (248) 551-8305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sruff67997@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028001629 MI Practitioner - Geriatric Medicine 9537390497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
William Beaumont HospitalGroup PAC ID 9335051093, 20 clinicians

Practice addresses (Care Compare)

1949 W 12 Mile Rd
100 Cor HLTH Univ Hosp
Berkley, MI 48072-1868
Phone (248) 551-0615

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Nov 1, 2017 Accepting new patients
William Beaumont Hospital Current Accepting new patients
William Beaumont Hospital CurrentSince Oct 31, 2014 Accepting new patients
William Beaumont Hospital CurrentSince Oct 31, 2014 Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

1949 W 12 Mile Rd
Ste 100
Berkley, MI 48072
Phone (248) 551-0615

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

3601 W 13 Mile Rd
Royal Oak, MI 48073

130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250

Organizations & group practices 5

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1184941841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 W 12 MILE RD",
            "address_2": "#100",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721868",
            "telephone_number": "248-551-8305",
            "fax_number": "248-551-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 W 12 MILE RD",
            "address_2": "#100",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721868",
            "telephone_number": "248-551-1756",
            "fax_number": "248-551-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFF",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018589",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "5101018589",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "5101018589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sruff67997@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "1949 W 12 Mile Rd",
            "address_2": "#100",
            "city": "Berkley",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480721868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.