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Individual provider Active NPI

Alexander Grant Ruthven II, MD

  • Family Medicine Physician
  • Port Huron, MI
National Provider Identifier
1194757864
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301030880 Issued in MI
Practice address
1225 10TH St
Huron Family Practice Center
Port Huron, MI 48060-5205
Phone
(810) 987-6200
Fax
(810) 987-8717
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301030880 MI Primary

Addresses

Primary practice location

1225 10TH St
Huron Family Practice Center
Port Huron, MI 48060-5205

Mailing address

1225 10TH St
Port Huron, MI 48060-5205
Phone (810) 987-6200

Other identifiers 2

IdentifierTypeStateIssuer
3042443MedicaidMI
4301030880OtherMIPHYSICIAN LICENSE

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
I20100211000669 MI Practitioner - Family Practice 0749387280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1971
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Huron Family Practice Center PCGroup PAC ID 9133154586, 4 clinicians

Practice addresses (Care Compare)

1225 10TH St
Port Huron, MI 48060-5205

Hospital & facility affiliations

  • Beacon Home Care Home health agency, Port Huron, MI, CCN 237440
  • McLaren Home Health Home health agency, Clinton Township, MI, CCN 237172
  • Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
  • Vna Home Health Care Home health agency, Port Huron, MI, CCN 237059
  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216
  • Lake Huron Medical Center Hospital, Port Huron, MI, CCN 230031
  • Marwood Manor Nursing Home Nursing home, Port Huron, MI, CCN 235369

Merit-based Incentive Payment System (MIPS)

Final score
97.42 of 100Reported as group
Quality
100
Promoting interoperability
84
Improvement activities
40
Cost
82.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301030880MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Family Practice Center PC Family Medicine CurrentSince May 2, 1994 Accepting new patients
McLaren Port Huron Past Accepting new patients
Prime Healthcare Services-Port Huron LLC Past Accepting new patients

Locations

1225 10th St
Port Huron, MI 48060
Phone (810) 987-6200

Organizations & group practices 3

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 8

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1194757864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 10TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480605205",
            "telephone_number": "810-987-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 10TH ST",
            "address_2": "HURON FAMILY PRACTICE CENTER",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480605205",
            "telephone_number": "810-987-6200",
            "fax_number": "810-987-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHVEN",
        "first_name": "ALEXANDER",
        "middle_name": "GRANT",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301030880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3042443",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301030880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.