1. Home
  2. Directory
  3. Michigan
  4. Wyoming
  5. Psychiatry Neurology
  6. NPI Profile

RUDOLPH OBO ADDY MD
NPI 1003839168
Psychiatry & Neurology - Psychiatry in Wyoming, MI

Active since July 26, 2006PECOS Enrolled
2093 HEALTH DR SW, WYOMING, MI 49519(616) 252-5760 Get Directions Write a Review

NPPES record last updated: September 24, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 24, 2020, Oct 16, 2019, Feb 3, 2016 (3 updates tracked since 2016).

About Rudolph Obo Addy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUDOLPH OBO ADDY MD (NPI 1003839168) is an individual psychiatry provider in Wyoming, Michigan, licensed in Michigan (4301042270) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1003839168
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameRUDOLPH OBO ADDYCredential: MD
Location Address2093 HEALTH DR SWWyoming, MI 49519-9691
Mailing Address5900 Byron Center Ave SwWyoming, MI 49519-9606
Phone(616) 252-5760
Sole ProprietorNo
Enumeration DateJuly 26, 2006
Last NPPES UpdateSeptember 24, 20203 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2020
✔ NPI 1003839168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in MI · 4301042270
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedPsychiatry & Neurology · Sleep MedicineTaxonomy 2084S0012X · License 4301042270 (MI)
2093 HEALTH DR SW, Wyoming, MI 49519
Open in Google Maps ↗

Secondary Practice Location 1

Location 14100 Lake Dr SE, S-100Grand Rapids, MI 49546-8292 · Phone (616) 391-3759

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rudolph Obo Addy Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Rudolph Addy reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Metropolitan Hospital
0.2 mi
Internal Medicine
5900 BYRON CENTER AVE SW
Wyoming, MI 49519
  • Reassigned Medicare billing, Michigan enrollment
  • 685 clinicians in this Medicare group
NPI 1811937519 (616) 252-7200
Advantage Health Saint Mary's Medical Group
0.7 mi
Orthopaedic Surgery
2373 64TH ST SW STE 2700
Byron Center, MI 49315
  • Reassigned Medicare billing, Michigan enrollment
  • 737 clinicians in this Medicare group
NPI 1003515008 (616) 465-5910

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.68 typical visit price
range $54.34 – $166.68
Typical copayment $41.67 (range $13.58 – $41.67)
Most-billed visit code 99205
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
10 suppliers37 claims37 services$32.31 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers18 claims18 services$76.33 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers16 claims32 services$30.51 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers17 claims85 services$13.98 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
8 suppliers31 claims31 services$46.17 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
14 suppliers32 claims32 services$16.10 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM MARC KATZ MD
Internal Medicine (Sleep Medicine)
2093 HEALTH DR SW, STE 200
WYOMING, MI 49519
Kent County (616) 459-3158
JOHN W HAMERSMA M.D.
Family Medicine
2093 HEALTH DR SW, STE 200
WYOMING, MI 49519
Kent County (616) 459-3158
MR. GREGORY LAPPETITO AGAC-NP
Nurse Practitioner (Acute Care)
2093 HEALTH DR SW
WYOMING, MI 49519
Kent County (616) 252-5775
GREATER GRAND RAPIDS PULMONARY AND CRITICAL CARE SPECIALISTS PC
Internal Medicine (Pulmonary Disease)
2093 HEALTH DR SW, #301
WYOMING, MI 49519
Kent County (616) 241-3500
MICHAEL J BULTJE DO
Family Medicine
2093 HEALTH DR SW, STE 200
WYOMING, MI 49519
Kent County (616) 459-3158
OSKAR AMADEUSZ WIELGUS MD
Psychiatry & Neurology (Sleep Medicine)
2093 HEALTH DR SW
WYOMING, MI 49519
Kent County (616) 252-7264
PAMELA KAY HENION FNP-BC
Nurse Practitioner (Family)
2093 HEALTH DR SW
WYOMING, MI 49519
Kent County (616) 252-5775
DR. THOMAS V BILISKO MD
Internal Medicine
2093 HEALTH DR SW, STE 200
WYOMING, MI 49519
Kent County (616) 459-3158

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rudolph Addy's NPI number?

The NPI number for Rudolph Addy is 1003839168. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Rudolph Addy located?

Rudolph Addy practices at 2093 Health Dr SW, Wyoming, MI 49519. The listed phone number is (616) 252-5760.

What is Rudolph Addy's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Rudolph Addy enrolled in Medicare?

Yes. Rudolph Addy is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Rudolph Addy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rudolph Addy reassigns Medicare benefits to 2 organizations: Metropolitan Hospital (Wyoming, MI) and Advantage Health Saint Mary's Medical Group (Byron Center, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rudolph Addy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rudolph Addy accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Rudolph Addy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rudolph Addy was last updated on September 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.