Individual provider Active NPI

Steven L Ventrudo, MD

  • Family Medicine Physician
  • Tappan, NY
National Provider Identifier
1265432736
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
166157-1 Issued in NY
Practice address
97 Route 303
Tappan, NY 10983-2514
Phone
(845) 359-5005
Fax
(845) 359-7890
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 166157-1 NY Primary

Addresses

Primary practice location

97 Route 303
Tappan, NY 10983-2514

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
01026824MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20171025001348 FL Practitioner - Family Practice 4789721515 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166157-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Current Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince May 1, 2020 Accepting new patients
Inpatient Consultants of Florida, Inc CurrentSince May 1, 2020 Accepting new patients

Locations

1501 SE 24th Rd
Ocala, FL 34471
Phone (352) 257-7777

2029 Professional Center Dr
Orange Park, FL 32073
Phone (570) 352-3063

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1265432736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 ROUTE 303",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109832514",
            "telephone_number": "845-359-5005",
            "fax_number": "845-359-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTRUDO",
        "first_name": "STEVEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "166157-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01026824",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tappan, NY

Sources for this page

Verify at the official NPI Registry.