Ada Ruderman, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

205782 Issued in NY

Practice address

1208 Avenue Z
Brooklyn, NY 11235-4302

Phone

(718) 368-2699

Fax

(718) 368-2544

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

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.

• Ada Ruderman Medical PC

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1679844401
  Medicare reassignment NPD Authorized official
• University Group Medical Associates, P.C

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1285683102
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114084399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354302",
            "telephone_number": "718-368-2699",
            "fax_number": "718-368-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354302",
            "telephone_number": "718-368-2699",
            "fax_number": "718-368-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDERMAN",
        "first_name": "ADA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "205782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01750150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Chester Rucinski, MD
• Bela Rud, LCSW
• Frances Rudden, LCSW
• Monique J Rudder
• Gianna L Ruddock, LCSW
• Battia Ruderman
• Tatyana Ruderman, M.D.
• Diana Rudgayzer
• Sarah Rudge
• Meira Rudich, SPECIAL ED

• Pediatric Adolescent Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Adolescent Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.