Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathleen Ruffolo

Individual provider Family Nurse Practitioner · NPI 1508412826

Kathleen Ruffolo is a Nurse Practitioner in Royal Oak, Michigan. Qualified in 2018, 8 years ago. Practices with Beaumont Medical Group- Specialty Services, a 858-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
8
Licensed in
MI
In the registry since
2019
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Practice location Address checks out

3535 W 13 Mile Rd Ste 404
Royal Oak, MI 48073-6770
Phone: (248) 551-3535
Fax: (248) 551-3311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704286622 (MI)

Record details

NPI number1508412826
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 13, 2019
Last updated in NPPESOctober 1, 2024
Certification dateOctober 1, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Beaumont Medical Group- Specialty Services — 858 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Royal Oak