Maury Ruben Ellenberg, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301034191 Issued in MI

Practice address

28455 Haggerty Rd
Suite 200
Novi, MI 48377-2982

Phone

(248) 893-3200

Fax

(248) 893-2950

NPI assigned

Oct 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rppcpt PLLC

  • Physical Therapist
  • Novi, MI
  • NPI 1245879535
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1245228790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6676 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776006",
            "telephone_number": "248-893-3220",
            "fax_number": "248-893-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28455 HAGGERTY RD",
            "address_2": "SUITE 200",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772982",
            "telephone_number": "248-893-3200",
            "fax_number": "248-893-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBERG",
        "first_name": "MAURY",
        "middle_name": "RUBEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301034191",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MI",
            "license": "4301034191",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "4301034191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4212207",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kholood Elhady
• Mohamed Elhady
• Elite Family Dental
• Ella Mae Elkildani
• Christina Elkins
• Michael J Ellenberg, MD
• Erik Brian Eller, MD
• Ellie Mental Health Live Authentic PLLC (Ellie Mental Health)
• Lauren Beverly Ellington
• Akgoneste Melyaha Elliott

• Physical Medicine & Rehabilitation Physician in Novi, MI
• Providers in Novi, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.