Active NPI
Phyllidia M. Ku-Ruth, MD
- Internal Medicine Physician
- Portland, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 015348
- Practice address
- 84 Marginal Way
Suite 800
Portland, ME 04101-2443 - Phone
- (207) 774-5816
- Fax
- (207) 774-7831
- NPI assigned
- Mar 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 015348 | ME | Primary |
Addresses
Primary practice location
84 Marginal Way
Suite 800
Portland, ME 04101-2443
Mailing address
100 Gannett Dr Ste C
South Portland, ME 04106-5900
Phone (207) 347-2947
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2456790 | Other | AETNA | |
| 309140099 | Medicaid | ME | |
| 061137 | Other | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Warren Alpert Medical School of Brown University, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Foden Rd
South Portland, ME 04106-2327
Phone (207) 874-1489
Hospital & facility affiliations
- Northern Light Home Care & Hospice
- Andwell Health Partners
- Mainehealth Maine Medical Center
- Mainehealth Mid Coast Hospital
- Northern Light Mercy Hospital
- Lincolnhealth
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015348 | ME | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermed, PA | Internal Medicine | Current | Accepting new patients |
| Intermed, PA | Current | Accepting new patients |
Locations
84 Marginal Way
Ste 800
Portland, ME 04101
Phone (207) 774-5816
84 Marginal Way
Ste 700
Portland, ME 04101
Phone (207) 347-2898
238 Western Ave
South Portland, ME 04106
Phone (207) 767-2174
100 Foden Rd
Ste 201
South Portland, ME 04106
Phone (207) 828-0361
100 Foden Rd
Ste 100
South Portland, ME 04106
Phone (207) 874-1489
100 Foden Rd
South Portland, ME 04106
Phone (207) 828-1122
100 Foden Rd
Ste W-100
South Portland, ME 04106
Phone (207) 523-3900
100 Foden Rd
Ste W-203
South Portland, ME 04106
Phone (207) 523-3900
100 Gannett Dr
Ste C
South Portland, ME 04106
Phone (207) 523-3649
Interoperability endpoints
- phyllidia.kuruth@int.eclinicaldirectplus.com
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- South Portland, ME
- NPI 1467422733
-
- Pediatrics Physician
- South Portland, ME
- NPI 1295607836
Hospital & facility affiliations 42
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Scarborough, ME
- NPI 1972594232
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1497724108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 GANNETT DR STE C",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041065900",
"telephone_number": "207-347-2947",
"fax_number": "207-874-2317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 MARGINAL WAY",
"address_2": "SUITE 800",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041012443",
"telephone_number": "207-774-5816",
"fax_number": "207-774-7831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KU-RUTH",
"first_name": "PHYLLIDIA",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-15",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ME",
"license": "015348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2456790",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "309140099",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "061137",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.