Individual provider Active NPI

Nichelle Ruffin, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1396364998
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD482395 Issued in PA
Practice address
3737 Market St FL 9
Philadelphia, PA 19104-5545
Phone
(216) 310-5993
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD482395 PA Primary

Addresses

Primary practice location

3737 Market St FL 9
Philadelphia, PA 19104-5545

Mailing address

4265 E 189TH St
Cleveland, OH 44122-6913
Phone (216) 310-5993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231010002540 PA Practitioner - Family Practice 7214359934 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3600 Civic Ctr Blvd
3E
Philadelphia, PA 19104-4310

3701 Market St
Philadelphia, PA 19104-5502
Phone (215) 662-2250

3737 Market St
Philadelphia, PA 19104-5545
Phone (215) 662-8777

3801 Filbert St
Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

5000 Woodland Ave
Philadelphia, PA 19143-5137
Phone (215) 726-9807

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD482395PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Sep 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Greater Philadelphia Health Action Inc. Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Greater Philadelphia Health Action Inc. Current Accepting new patients
Trustees of the University of Pennsylvania Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Greater Philadelphia Health Action, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

3737 Market St
Fl 9
Philadelphia, PA 19104
Phone (215) 294-9284

700 Spruce St
Ste 305
Philadelphia, PA 19106
Phone (215) 829-2092

432 N 6th St
Philadelphia, PA 19123
Phone (215) 627-8000

3737 Market St
#9
Philadelphia, PA 19104
Phone (215) 294-9525

1401 S 31st St
Philadelphia, PA 19146
Phone (215) 755-7700

5501 Woodland Ave
Philadelphia, PA 19143
Phone (215) 724-4700

3400 Spruce St
Fl 6
Philadelphia, PA 19104
Phone (215) 615-0800

5000 Woodland Ave
Philadelphia, PA 19143
Phone (215) 726-9807

Interoperability endpoints

  • Direct secure messaging: nichelle.ruffinmd.p1@direct.gpha.nextgenshare.com

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1396364998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 E 189TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441226913",
            "telephone_number": "216-310-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARKET ST FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "216-310-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "NICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD482395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.