Ellen Ruby, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R-028959-1 Issued in NY

Practice address

26 Club LN
Sag Harbor, NY 11963-2112

Phone

(631) 725-1769

Fax

(631) 725-1769

NPI assigned

Mar 12, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Clinical Social Worker

Education

State University of New York at Stony Brook, School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1299888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299888000000",
    "number": "1164720306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CLUB LN",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119632112",
            "telephone_number": "631-725-1769",
            "fax_number": "631-725-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CLUB LN",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119632112",
            "telephone_number": "631-725-1769",
            "fax_number": "631-725-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY",
        "first_name": "ELLEN",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-12",
        "last_updated": "2011-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "CASAC2385",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-028959-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard J. Richter, Podiatrist, P.C
• Richard Jay Richter, DPM
• Laura Antonia Rinaldi, LMHC
• Susan Roman, PT, DPT
• Toni Rozzi
• Shirley A Ruch, M.A., CCC-SP
• Sag Harbor Pharmacy Inc
• Sag Harbor Skin and Aesthetics LLC
• Sag Harbor Ufsd
• Sagaponack Medical PC

• Clinical Social Worker in Sag Harbor, NY
• Providers in Sag Harbor, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.