Individual provider Active NPI

Ruben N Rosario, PSY.D

  • Psychologist
  • Bronx, NY
National Provider Identifier
1063783843
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
022066 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
Fax
(718) 299-6797
NPI assigned
Jan 25, 2012
Last updated
Aug 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4197 PR
Psychologist 103T00000X 022066 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

1434 Williamsbridge Rd
Bronx, NY 10461-2507
Phone (718) 618-0401

Other names 1

  • Mr. Ruben N Rosario Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, FL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170531000522 NY Practitioner - Clinical Psychologist 4183991854 Reassigns benefits to 4 organizations
I20210629000337 TX Practitioner - Clinical Psychologist 4183991854 Reassigns benefits to 2 organizations
I20231129001921 FL Practitioner - Clinical Psychologist 4183991854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shakespeare Operating LLCGroup PAC ID 0840604310, 144 clinicians
Essen Medical Associates, PCGroup PAC ID 1759353501, 264 clinicians

Practice addresses (Care Compare)

1250 Shakespeare Ave
Bronx, NY 10452-3012
Phone (646) 350-1633

2505 Grand Ave
Bronx, NY 10468-4206
Phone (718) 295-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4197PRMDProfessional Counselor
38609TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychologist Current Accepting new patients
Grow Healthcare Group PA Psychologist CurrentSince Nov 1, 2023 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Mar 30, 2018 Accepting new patients
Essen Medical Associates, PC CurrentSince Sep 1, 2017 Accepting new patients
Rhapsody Counseling and Wellness Center PC CurrentSince Jun 1, 2021 Accepting new patients
Shakespeare Operating LLC CurrentSince Dec 18, 2020 Accepting new patients
Essen Medical Associates, PC CurrentSince Sep 1, 2017 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1250 Shakespeare Ave
Bronx, NY 10452
Phone (646) 350-1633

1434 Williamsbridge Rd
Bronx, NY 10461
Phone (718) 597-1434

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2015 Grand Concourse
#13202
Bronx, NY 10453

2445 Arthur Ave
Bronx, NY 10458
Phone (718) 220-3434

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

11901 Toepperwein Rd
Ste 1106
Live Oak, TX 78233
Phone (210) 286-9339

12702 Toepperwein Rd
Ste 236
Live Oak, TX 78233
Phone (210) 286-9339

Networks

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

Interoperability endpoints

  • Direct secure messaging: ruben.rosario@ema.eclinicaldirectplus.com
  • Direct secure messaging: rubenrosario@tdh.allscriptsdirect.net

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1063783843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 WILLIAMSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612507",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "RUBEN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "4197",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUBEN",
            "last_name": "ROSARIO",
            "middle_name": "N",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.