MEDPRO PRIMARY CARE PLLC
NPI 1639700107
Internal Medicine in New Boston, MI
About Medpro Primary Care Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEDPRO PRIMARY CARE PLLC (NPI 1639700107) is a healthcare organization registered as an internal medicine in New Boston, Michigan and active in the NPI registry since February 2020. The organization holds 2 active CLIA laboratory certificates and lists Joshua Ruedisueli, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Medpro Primary Care Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Medpro Primary Care PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 23D2178151
Medpro Primary Care PLLC · New Boston, MICertificate of Waiver 23D2264709
Medpro Primary Care PLLC · New Boston, MIFrequently 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 Medpro Primary Care PLLC's NPI number?
The NPI number for Medpro Primary Care PLLC is 1639700107. It was assigned to this organization in the NPPES registry on February 3, 2020.
Where is Medpro Primary Care PLLC located?
Medpro Primary Care PLLC is located at 17901 Huron River Dr, New Boston, MI 48164. The listed phone number is (734) 315-7070.
What is Medpro Primary Care PLLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Medpro Primary Care PLLC enrolled in Medicare?
Yes. Medpro Primary Care PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Medpro Primary Care PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Medpro Primary Care PLLC, in Family Practice, Internal Medicine and Nurse Practitioner. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Medpro Primary Care PLLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Medpro Primary Care PLLC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Medpro Primary Care PLLC 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 Medpro Primary Care PLLC was last updated on February 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Medpro Primary Care Pllc · NPI 1639700107
Internal Medicine organization in New Boston, Michigan. Organization record, active in the CMS NPPES registry since February 3, 2020.
## Identity
- **NPI:** 1639700107 (Entity type: Organization)
- **Enumerated:** February 3, 2020
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Joshua Ruedisueli, OWNER
## Practice location
- **Address:** 17901 HURON RIVER DR, New Boston, MI 48164-3200
- **Phone:** (734) 315-7070
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Family Practice (1), Internal Medicine (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 11, 2021
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1639700107) · Data from the CMS NPPES public registry.