Individual provider Active NPI

Casey Jerome Reulbach, DO

  • Internal Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1235703042
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5151014895 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5000
NPI assigned
May 17, 2021
Last updated
May 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5151014895 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

1634 Woodard Rd
Webster, NY 14580-9727
Phone (585) 217-3528

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220325000220 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4486049657

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1235703042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 WOODARD RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145809727",
            "telephone_number": "585-217-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REULBACH",
        "first_name": "CASEY",
        "middle_name": "JEROME",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5151014895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.