NPIMap

Individual provider Active NPI

William M Rudy, D.O.

  • Internal Medicine Physician
  • Berkley, MI
National Provider Identifier
1790797207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101007799 Issued in MI
Practice address
2635 Coolidge Hwy
Berkley, MI 48072-1554
Phone
(248) 541-2512
Fax
(248) 541-0232
NPI assigned
Aug 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101007799 MI Primary

Addresses

Primary practice location

2635 Coolidge Hwy
Berkley, MI 48072-1554

Mailing address

2635 Coolidge Hwy
Berkley, MI 48072-1554
Phone (248) 541-2512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100219000420 MI Practitioner - Internal Medicine 9032106794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Health Care PCGroup PAC ID 4981849320, 4 clinicians
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

2635 Coolidge Hwy
Berkley, MI 48072-1554
Phone (248) 541-2512

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Health Care, P.C. Internal Medicine CurrentSince Feb 15, 2013 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

2635 Coolidge Hwy
Berkley, MI 48072
Phone (248) 541-2512

29911 6 Mile Rd
Livonia, MI 48152
Phone (734) 513-1600

22021 Ecorse Rd
Taylor, MI 48180
Phone (313) 291-4444

Interoperability endpoints

  • Direct secure messaging: william.rudy@839051433279492.direct.elationemr.com
  • Direct secure messaging: wrudy1149743@direct.hfhs.org

Organizations & group practices 3

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790797207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721554",
            "telephone_number": "248-541-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721554",
            "telephone_number": "248-541-2512",
            "fax_number": "248-541-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDY",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101007799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.