Individual provider Active NPI

Erlyn Rudico

  • Anesthesiology Physician
  • Kalamazoo, MI
National Provider Identifier
1669036265
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5101027942 Issued in MI
Practice address
900 Peeler St
Kalamazoo, MI 49008-2300
Phone
(269) 345-8618
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5101027942 MI Primary

Addresses

Primary practice location

900 Peeler St
Kalamazoo, MI 49008-2300

Mailing address

PO Box 2405
Indianapolis, IN 46206-2405
Phone (269) 345-8618

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808003700 MI Practitioner - Anesthesiology 5496143737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Western University of Health Sciences College of Dental Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalamazoo Anesthesiology P CGroup PAC ID 3375449473, 135 clinicians

Practice addresses (Care Compare)

125 W Walnut St
Bronson Outpatient Surgery Cener
Kalamazoo, MI 49007-5239
Phone (269) 343-1381

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-7000

408 Hazen St
Paw Paw, MI 49079-1019
Phone (269) 657-3141

900 Peeler St
Kalamazoo, MI 49008-2300
Phone (269) 345-8618

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo Anesthesiology P C Anesthesiology CurrentSince Aug 9, 2024 Accepting new patients

Locations

900 Peeler St
Kalamazoo, MI 49008
Phone (269) 345-8618

Organizations & group practices 1

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1669036265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2405",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062405",
            "telephone_number": "269-345-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082300",
            "telephone_number": "269-345-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDICO",
        "first_name": "ERLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101027942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.