Individual provider Active NPI

Tammera Ruettinger, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Ypsilanti, MI
National Provider Identifier
1194251256
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704267561 Issued in MI
Practice address
5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone
(734) 755-2243
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704267561 MI Primary

Addresses

Primary practice location

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Mailing address

637 John Rolfe Dr
Monroe, MI 48162-3316
Phone (734) 755-2243

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719002540 MI Practitioner - Nurse Practitioner 7517360233 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital CurrentSince Nov 19, 2022 Accepting new patients
Iha Health Service Corporation CurrentSince Feb 1, 2023 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Apr 17, 2021 Accepting new patients
Iha Health Services Corporation CurrentSince Feb 1, 2023 Accepting new patients
St Joseph Mercy Hospital CurrentSince Nov 19, 2022 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Apr 17, 2021 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

Organizations & group practices 8

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1194251256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 JOHN ROLFE DR",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623316",
            "telephone_number": "734-755-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-755-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUETTINGER",
        "first_name": "TAMMERA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704267561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.