Family Health NP Immediate Care, PLLC
Organization Active NPI Nurse Practitioner · Ontario, NY
NPI 1104396274 · NPPES record last updated Jan 9, 2025
Key facts
- NPI
- 1104396274
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- FAMILY HEALTH NP IMMEDIATE CARE, PLLC
- Practice address
- 6280 Furnace Road
Ontario, NY 14519 - Phone
- (315) 791-0050
- NPI assigned
- Nov 30, 2018
- Organization subpart
- No
Authorized official
- Name
- Denise H. Ruiz, F.N.P.
- Title
- Member
- Phone
- (585) 831-9428
Practitioners 7
-
Denise H Ruiz, MS, FNP-C
-
Heidi M Deford, NP
-
Megan Dierks, FNP
-
Robin Stacy, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2178517 | Family Health NP Immediate Care PLLC | Certificate of waiver | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231002000315 | NY | Part B Supplier - Clinic/Group Practice | 5193179786 |
Receives reassigned benefits from 7 practitioners Practice locations: Ontario, NY |
National Provider Directory
Locations
6280 Furnace Rd
Ste 600
Ontario, NY 14519
Phone (315) 791-0050
6280 Furnace Rd
Ontario, NY 14519
Phone (315) 791-0050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
6280 Furnace Road
Ontario, NY 14519
Mailing address
6280 Furnace Road
Ontario, NY 14519
Phone (315) 791-0050
NPI Registry JSON
{
"created_epoch": "1543536000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736380800000",
"number": "1104396274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6280 FURNACE ROAD",
"city": "ONTARIO",
"state": "NY",
"postal_code": "14519",
"telephone_number": "315-791-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6280 FURNACE ROAD",
"city": "ONTARIO",
"state": "NY",
"postal_code": "14519",
"telephone_number": "315-791-0050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HEALTH NP IMMEDIATE CARE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-11-30",
"last_updated": "2025-01-09",
"certification_date": "2025-01-09",
"status": "A",
"authorized_official_last_name": "RUIZ",
"authorized_official_first_name": "DENISE",
"authorized_official_middle_name": "H.",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "585-831-9428",
"authorized_official_credential": "F.N.P."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, NY
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- Robert Durham
- Stephanie Duvall-Swartzenberg
- Pamela C Elsbree
- Anne Falen
- Robin L Fedison
- Sheila Marie Fell-Loftus
- Deborah Jo Fell
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All providers in Ontario, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.