Individual provider Active NPI

Marisa Ruiz, RN

  • Registered Nurse
  • Suffern, NY
National Provider Identifier
1083936751
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
612813 Issued in NY
Practice address
99 Washington Ave
Suffern, NY 10901-6026
Phone
(745) 357-4500
Fax
(845) 357-5039
NPI assigned
Feb 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 612813 NY Primary

Addresses

Primary practice location

99 Washington Ave
Suffern, NY 10901-6026

Mailing address

7 Elm St
Highland Mills, NY 10930-5128
Phone (745) 216-4471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
612813NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1083936751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ELM ST",
            "city": "HIGHLAND MILLS",
            "state": "NY",
            "postal_code": "109305128",
            "telephone_number": "745-216-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 WASHINGTON AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109016026",
            "telephone_number": "745-357-4500",
            "fax_number": "845-357-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "MARISA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "612813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.