NPIMap

Individual provider Active NPI

Kelli M. Ruby, DO

  • Psychiatry Physician
  • Butler, PA
National Provider Identifier
1659799427
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS019498 Issued in PA
Practice address
901 E Brady St Ste 103
Butler, PA 16001
Phone
(724) 282-1627
NPI assigned
Mar 31, 2014
Last updated
Oct 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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 259678 MA
Psychiatry Physician 2084P0800X OS019498 PA Primary

Addresses

Primary practice location

901 E Brady St Ste 103
Butler, PA 16001

Mailing address

901 E Brady St Ste 103
Butler, PA 16001-4649
Phone (724) 282-1627

Other practice location 1

901 E Brady St Ste 103
Butler, PA 16001
Phone (724) 282-1627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20181219001190 PA Practitioner - Psychiatry 5799902540 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PBS Mental Health Associates PCGroup PAC ID 8022068063, 10 clinicians

Practice addresses (Care Compare)

155 Wellness Way
State College, PA 16803-6797
Phone (814) 231-7000

901 E Brady St
Suite 103
Butler, PA 16001-4649
Phone (724) 282-1627

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Jul 9, 2024 Accepting new patients
PBS Mental Health Associates, P.C. Psychiatry CurrentSince Oct 27, 2018 Accepting new patients
Mount Nittany Medical Center Health Services Inc CurrentSince Sep 1, 2025 Accepting new patients
Steward Medical Group Inc. CurrentSince Jul 9, 2024 Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

901 E Brady St
Ste 103
Butler, PA 16001
Phone (724) 282-1627

2375 Garden Way
Hermitage, PA 16148
Phone (724) 983-5454

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

951 Male Rd
Wind Gap, PA 18091
Phone (610) 654-1000

Organizations & group practices 4

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 5

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1659799427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E BRADY ST STE 103",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160014649",
            "telephone_number": "724-282-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E BRADY ST STE 103",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "16001",
            "telephone_number": "724-282-1627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Brady St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Butler",
            "state": "PA",
            "postal_code": "16001",
            "country_code": "US",
            "telephone_number": "724-282-1627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBY",
        "first_name": "KELLI",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "259678",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS019498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.