Individual provider Active NPI

Ruth B Klebansky

  • Emergency Medicine Physician
  • Demarest, NJ
National Provider Identifier
1154124378
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
033587-01 Issued in NY
Practice address
4 Adele Ave
Demarest, NJ 07627-2144
Phone
(201) 575-2561
NPI assigned
Mar 31, 2025
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 033587-01 NY Primary

Addresses

Primary practice location

4 Adele Ave
Demarest, NJ 07627-2144

Mailing address

4 Adele Ave
Demarest, NJ 07627-2144

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826000065 NY Practitioner - Physician Assistant 9234639071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033587-01NYMDEmergency Medicine Physician

Organizations & group practices 1

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1154124378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ADELE AVE",
            "city": "DEMAREST",
            "state": "NJ",
            "postal_code": "076272144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ADELE AVE",
            "city": "DEMAREST",
            "state": "NJ",
            "postal_code": "076272144",
            "telephone_number": "201-575-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEBANSKY",
        "first_name": "RUTH",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "033587-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Demarest, NJ

Sources for this page

Verify at the official NPI Registry.