Active NPI
Ruona Maria Bertaccini, SP.PATH., MS,CCC/SLP
- Speech-Language Pathologist
- New York, NY
National Provider Identifier
1124099304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 001699-1
- Practice address
- 536 W 111TH St
Apt. 64
New York, NY 10025-1981 - Phone
- (212) 678-6395
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 001699-1 | NY | Primary |
Addresses
Primary practice location
536 W 111TH St
Apt. 64
New York, NY 10025-1981
Mailing address
536 W 111TH St
Apt. 64
New York, NY 10025-1981
Phone (212) 678-6395
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001699-1 | Other | NY | STATE LICENSE |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001699 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124099304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 W 111TH ST",
"address_2": "APT. 64",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251981",
"telephone_number": "212-678-6395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "536 W 111TH ST",
"address_2": "APT. 64",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251981",
"telephone_number": "212-678-6395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTACCINI",
"first_name": "RUONA",
"middle_name": "MARIA",
"name_prefix": "Ms.",
"credential": "SP.PATH., MS,CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "001699-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "001699-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.