Individual provider Active NPI

Benjamin Edward Devlin-Ruelle, FNP-BC

  • Family Nurse Practitioner
  • Wyandotte, MI
National Provider Identifier
1598258477
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704274021 Issued in MI
Practice address
2025 Fort St
Wyandotte, MI 48192-3841
Phone
(734) 283-9640
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704274021 MI Primary

Addresses

Primary practice location

2025 Fort St
Wyandotte, MI 48192-3841

Mailing address

2025 Fort St.
Wyandotte, MI 48192-3841
Phone (734) 283-9640

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190806002779 MI Practitioner - Nurse Practitioner 4082941562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704274021MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Oct 3, 2020 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Oct 3, 2020 Accepting new patients

Locations

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1223 S Washington Ave
Royal Oak, MI 48067
Phone (248) 395-0080

28477 Hoover Rd
Warren, MI 48093
Phone (586) 250-4040

3803 Elizabeth Lake Rd
Waterford, MI 48328
Phone (248) 221-7733

35640 W Michigan Ave
Wayne, MI 48184
Phone (517) 630-2446

309 Ecorse Rd
Ypsilanti, MI 48198
Phone (734) 484-0580

Interoperability endpoints

  • Direct secure messaging: benjamindevlin-ruelle@gammons.directglo.com
  • Direct secure messaging: bdevlinruelle1125114@direct.hfhs.org

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.

Hospital & facility affiliations 1

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1598258477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FORT ST.",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923841",
            "telephone_number": "734-283-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 FORT ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923841",
            "telephone_number": "734-283-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLIN-RUELLE",
        "first_name": "BENJAMIN",
        "middle_name": "EDWARD",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704274021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.