Individual provider Active NPI

Sonali Ruder, D.O.

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1003950429
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02677329 Issued in NY
Practice address
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Phone
(718) 918-3060
Fax
(718) 918-4469
NPI assigned
Feb 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02677329 NY Primary

Addresses

Primary practice location

1400 Pelham Pkwy S
Bronx, NY 10461-1138

Mailing address

350 W 42ND St
Apt. 32B
New York, NY 10036-6945
Phone (516) 317-5978

Other identifiers 1

IdentifierTypeStateIssuer
02677329MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120815000722 FL Practitioner - Emergency Medicine 4486838364 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02677329NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients

Locations

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157

Interoperability endpoints

  • Direct secure messaging: sonali.ruder.1@25843.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1003950429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 42ND ST",
            "address_2": "APT. 32B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366945",
            "telephone_number": "516-317-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-3060",
            "fax_number": "718-918-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDER",
        "first_name": "SONALI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "02677329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02677329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.