Active NPI
Sonali Ruder, D.O.
- Emergency Medicine Physician
- Bronx, NY
National Provider Identifier
1003950429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 02677329
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02677329 | Medicaid | NY |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02677329 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Emergency Medicine of Broward LLC | Emergency Medicine | Current | Accepting new patients |
| Phoenix Emergency Medicine of Broward LLC | Emergency Medicine | Current | 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
- 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.
-
- Emergency Medicine Physician
- Coral Springs, FL
- NPI 1871542969
-
- Emergency Medicine Physician
- Deerfield Beach, FL
- NPI 1407805591
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.