1. Home
  2. Directory
  3. Michigan
  4. New Boston
  5. Internal Medicine
  6. NPI Profile

MEDPRO PRIMARY CARE PLLC
NPI 1639700107
Internal Medicine in New Boston, MI

Active since February 03, 2020CLIA 23D2178151 · Waiver
17901 HURON RIVER DR, NEW BOSTON, MI 48164(734) 315-7070 Get Directions Write a Review

NPPES record last updated: February 11, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2021, Feb 22, 2020, Feb 3, 2020 (3 updates tracked since 2020).

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 a CLIA Waiver certificate valid through January 27, 2028 and lists Joshua Ruedisueli, Owner, as its authorized official.

NPPES Registry Identity

NPI1639700107
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMEDPRO PRIMARY CARE PLLC
Location Address17901 HURON RIVER DRNew Boston, MI 48164-3200
Mailing Address17901 Huron River DrNew Boston, MI 48164-3200 · (734) 315-7070
Phone(734) 315-7070
Organization SubpartNo
Authorized OfficialJoshua RuedisueliOwner · (734) 315-7070
Enumeration DateFebruary 3, 2020
Last NPPES UpdateFebruary 11, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2021
✔ NPI 1639700107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
17901 HURON RIVER DR, New Boston, MI 48164
Open in Google Maps ↗

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 and more.Insurance ›

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, MI
Active · expires Jan 27, 2028
CLIA Number23D2178151
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2026
Certificate Expiration DateJanuary 27, 2028
Laboratory DirectorDaniel V. Kapadia
Laboratory Phone(248) 379-1728
Laboratory LocationMedpro Primary Care PLLC17901 Huron River Drive, New Boston, MI 48164
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2264709

Medpro Primary Care PLLC · New Boston, MI
Expired · Jul 18, 2026
CLIA Number23D2264709
Laboratory TypePhysician Office
Certificate Effective DateJuly 19, 2024
Certificate Expiration DateJuly 18, 2026
Laboratory DirectorDaniel Kapadia
Laboratory Phone(734) 315-7070
Laboratory LocationMedpro Primary Care PLLC21057 Waltz Road, New Boston, MI 48164
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

DR. PAUL KENT VOREIS O.D.
Optometrist (Pediatrics)
17901 HURON RIVER DR, SUITE 101
NEW BOSTON, MI 48164
Wayne County (734) 753-9360
MAKK GROUP LLC
Nurse Practitioner
17901 HURON RIVER DR
NEW BOSTON, MI 48164
Wayne County (586) 634-5213
SAMANTHA EVELYN DEMARCE
Nurse Practitioner (Family)
17901 HURON RIVER DR
NEW BOSTON, MI 48164
Wayne County (734) 315-7070
VOREIS EYE CARE, P.C.
Optometrist
17901 HURON RIVER DR, SUITE 101
NEW BOSTON, MI 48164
Wayne County (734) 753-9360
JACLYN WEBER PA
Physician Assistant
17901 HURON RIVER DR
NEW BOSTON, MI 48164
Wayne County (734) 315-7070

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 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.

Does Medpro Primary Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2178151) is associated with this NPI, valid through January 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.