Individual provider Active NPI

Gary Lee Ruelle, M.D.

  • Family Medicine Physician
  • Waterford, MI
National Provider Identifier
1831280080
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301081689 Issued in MI
Practice address
5696 Dixie Hwy
Waterford, MI 48329-1618
Phone
(248) 623-8850
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301081689 MI Primary

Addresses

Primary practice location

5696 Dixie Hwy
Waterford, MI 48329-1618

Mailing address

5696 Dixie Hwy
Waterford, MI 48329-1618
Phone (248) 623-8850

Other identifiers 1

IdentifierTypeStateIssuer
4301081689OtherMILICENSE

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
I20061218000326 MI Practitioner - Family Practice 1153320262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5696 Dixie Hwy
Waterford, MI 48329-1618
Phone (248) 623-8850

Hospital & facility affiliations

  • Better You Home Health, LLC Home health agency, Dearborn, MI, CCN 239323
  • Corsocare Home Health Home health agency, Milford, MI, CCN 239129
  • Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301081689MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Strength & Health Medical PC Family Medicine CurrentSince Dec 1, 2007 Accepting new patients

Locations

5696 Dixie Hwy
Waterford, MI 48329
Phone (248) 623-8850

1305 N Oakland Blvd
Waterford, MI 48327
Phone (248) 666-5522

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 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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1831280080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5696 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483291618",
            "telephone_number": "248-623-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5696 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483291618",
            "telephone_number": "248-623-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUELLE",
        "first_name": "GARY",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-02-10",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301081689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301081689",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.