STANLEY RUDER (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1477099935
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for STANLEY RUDER (PMHNP)
261 M 62
Cassopolis, MI 490311034
Phone: (269) 445-3874
Fax: (269) 445-1930
Type: Location
1951 OAK ST
NILES, MI 491203738
Phone: (269) 262-4749
Fax: (269) 262-4739
Type: Mailing
Howard Brown Health Clark, 6500, North Clark Street, Rogers Park, Chicago, Rogers Park Township, Cook County, Illinois, 60626, United States
CHICAGO, IL 606264097
Phone: (773) 388-1600
Fax: (773) 564-4156
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: 2021-04-07
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 |
|---|---|---|---|---|
| I20210407002005 | I | Nurse Practitioner | MI | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49031)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | MI | |
| Physician Assistant | MI | |
| Clinical Social Worker | MI | |
| Family Practice | MI | |
| Family Practice | MD | |
| Family Practice | MI | |
| Physician Assistant | PA | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | MI |
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