Individual provider Active NPI

Elaine Ruiz, PHD

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1114750478
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS02366 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-4515
Fax
(401) 444-7018
NPI assigned
Aug 22, 2024
Last updated
Jul 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS02366 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4515

Other practice location 1

1 Hoppin St Ste 204
Providence, RI 02903-4141
Phone (401) 444-8945

Other practice location 2

1 Hoppin St Ste 1300
Providence, RI 02903-4132
Phone (401) 444-8945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250804001918 RI Practitioner - Clinical Psychologist 6901314749 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Psychologist CurrentSince Sep 21, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 21, 2025 Accepting new patients
Rhode Island Hospital Psychologist CurrentSince Sep 21, 2025 Accepting new patients
Rhode Island Hospital CurrentSince Sep 21, 2025 Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

1 Hoppin St
Ste 1300
Providence, RI 02903
Phone (401) 444-8945

1 Hoppin St
Ste 204
Providence, RI 02903
Phone (401) 444-8945

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

Organizations & group practices 4

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": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1114750478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4515",
            "fax_number": "401-444-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4515",
            "fax_number": "401-444-7018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hoppin St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034141",
            "country_code": "US",
            "telephone_number": "401-444-8945",
            "fax_number": "401-444-8742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hoppin St Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034132",
            "country_code": "US",
            "telephone_number": "401-444-8945",
            "fax_number": "401-444-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.