Individual provider Active NPI

Angella Dawn Ruley, CRNA, NP-C

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1851359921
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704187598 Issued in MI
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(952) 442-9770
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704187598 MI
Certified Registered Nurse Anesthetist 367500000X 4704187598 MI Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

Dept 203401
PO Box 67000
Detroit, MI 48267-0001
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
104718960MedicaidMI
AJ87598OtherMIBLUE CROSS OF MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050503000214 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789623307 Reassigns benefits to 3 organizations
I20220203000366 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789623307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2013 Accepting new patients
Henry Ford Health System CurrentSince Apr 15, 2013 Accepting new patients
A4 of Ohio, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 3, 2022 Accepting new patients
Michigan Family Medicine and Urgent Care CurrentSince Nov 1, 2022 Accepting new patients
Anesthesia Office Consultants, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

6531 W Michigan Ave
#C
Jackson, MI 49201
Phone (517) 750-3822

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

5959 Monclova Rd
Maumee, OH 43537
Phone (419) 251-3740

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

3330 Meijer Dr
#1
Toledo, OH 43617
Phone (419) 578-5020

Organizations & group practices 7

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 1

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1851359921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 203401",
            "address_2": "PO BOX 67000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670001",
            "telephone_number": "952-442-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "952-442-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULEY",
        "first_name": "ANGELLA",
        "middle_name": "DAWN",
        "credential": "CRNA, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704187598",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704187598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104718960",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MI",
            "identifier": "AJ87598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.