PHYLLIDIA M. KU-RUTH (MD) – Internal Medicine Physician, NPI 1497724108
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
916 INTERNAL MEDICINE in ME
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Provider Addresses for PHYLLIDIA M. KU-RUTH (MD)
Intermed Building, 84, Marginal Way, Downtown, Portland, Cumberland County, Maine, 04101, United States
SUITE 800
PORTLAND, ME 041012443
Phone: (207) 774-5816
Fax: (207) 774-7831
Type: Location
100 GANNETT DR STE C
SOUTH PORTLAND, ME 041065900
Phone: (207) 347-2947
Fax: (207) 874-2317
Type: Mailing
Foden Road, South Portland, Cumberland County, Maine, 04106, United States
SUITE 203
SOUTH PORTLAND, ME 041062319
Phone: (207) 828-0361
Fax: (207) 874-1483
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-11-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041129000507 | I | Internal Medicine | ME | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 329 | 174 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 181 | 146 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 158 | 111 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 127 | 127 | $0 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 116 | 106 | $0 |
Insurance plans in this area (ZIP 04101)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ME | |
| P S Y C H I A T R Y | ME | |
| Physical Therapist In Private Practice | ME | |
| Family Practice, Sports Medicine | ME | |
| Family Practice | ME | |
| Nurse Practitioner | ME | |
| Family Practice | ME | |
| - | ME | |
| - | ME | |
| Internal Medicine | ME |
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