Individual provider Active NPI

Ruth Tyan, NP

  • Nurse Practitioner
  • Bronxville, NY
National Provider Identifier
1003675935
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
432957 Issued in NY
Practice address
55 Palmer Ave
Bronxville, NY 10708-3403
Phone
(914) 787-1000
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 819042 NY
Nurse Practitioner 363L00000X 432957 NY Primary

Addresses

Primary practice location

55 Palmer Ave
Bronxville, NY 10708-3403

Mailing address

4828 Tonnelle Ave Apt 1216
North Bergen, NJ 07047-2987
Phone (973) 525-0986

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address RUT9018@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522003580 NY Practitioner - Nurse Practitioner 8426490475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Medical Associates PCGroup PAC ID 1759439631, 226 clinicians

Practice addresses (Care Compare)

55 Palmer Ave
Bronxville, NY 10708-3403
Phone (914) 787-1000

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
819042NYMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Medical Associates, PC CurrentSince Apr 20, 2024 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Apr 20, 2024 Accepting new patients

Locations

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

685 White Plains Rd
Lowr
Eastchester, NY 10709
Phone (914) 787-4100

685 White Plains Rd
Fl 2
Eastchester, NY 10709
Phone (914) 787-4100

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: rut9018@direct.nyp.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1003675935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 TONNELLE AVE APT 1216",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070472987",
            "telephone_number": "973-525-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PALMER AVE",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083403",
            "telephone_number": "914-787-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYAN",
        "first_name": "RUTH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "819042",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "432957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RUT9018@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "55 Palmer Ave",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "55 Palmer Ave",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "55 Palmer Ave",
            "city": "Bronxville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107083403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronxville, NY

Sources for this page

Verify at the official NPI Registry.