Organization Active NPI

Metro Medical Practice PC

  • Obstetrics & Gynecology Physician
  • Troy, MI
National Provider Identifier
1740223239
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
SJ033023 Issued in MI
Legal business name
METRO MEDICAL PRACTICE PC
Practice address
2891 E Maple Rd
Suite 102
Troy, MI 48083-6106
Phone
(248) 524-9085
Fax
(248) 524-9086
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Mrs. Natalia Rutkovsky
Title
Office Menager
Phone
(248) 524-9085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X SJ033023 MI Primary

Addresses

Primary practice location

2891 E Maple Rd
Suite 102
Troy, MI 48083-6106

Mailing address

2891 E Maple Rd
Suite 102
Troy, MI 48083-6106
Phone (248) 524-9085

Other identifiers 3

IdentifierTypeStateIssuer
132060OtherMICARE CHOICES
101958265MedicaidMI
700F325720OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Metro Medical Practice Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1740223239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD",
            "address_2": "SUITE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "248-524-9085",
            "fax_number": "248-524-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD",
            "address_2": "SUITE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "248-524-9085",
            "fax_number": "248-524-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO MEDICAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "RUTKOVSKY",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_title_or_position": "OFFICE MENAGER",
        "authorized_official_telephone_number": "248-524-9085",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "SJ033023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "132060",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101958265",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "700F325720",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Medical Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.