NPIMap

Individual provider Active NPI

Ruth Rosa Kamienecki, DO

  • Family Medicine Physician
  • Novi, MI
National Provider Identifier
1336116235
Registry record updated Nov 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101009199 Issued in MI
Practice address
44130 W 12 Mile Rd
Novi, MI 48377-2614
Phone
(248) 380-8811
Fax
(248) 380-3120
NPI assigned
Mar 1, 2006
Last updated
Nov 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2020

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 5101009199 MI Primary

Addresses

Primary practice location

44130 W 12 Mile Rd
Novi, MI 48377-2614

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1862

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkamienecki96357@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
I20091203000428 MI Practitioner - Family Practice 8527107556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

44130 W 12 Mile Rd
Corewell Health Farmington Hills Hospital F
Novi, MI 48377-2614
Phone (248) 380-8811

Hospital & facility affiliations

National Provider Directory

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

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

Locations

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

32754 Grand River Ave
Farmington Hls, MI 48336
Phone (248) 476-3280

44130 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 380-8811

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: rkamienecki96357@direct.beaumont.edu

Organizations & group practices 2

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 11

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605312000000",
    "number": "1336116235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1862",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44130 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772614",
            "telephone_number": "248-380-8811",
            "fax_number": "248-380-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMIENECKI",
        "first_name": "RUTH",
        "middle_name": "ROSA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-11-14",
        "certification_date": "2020-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkamienecki96357@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44130 W 12 Mile Rd",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483772614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.