Individual provider Active NPI

Lily Ruan

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1306997291
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
304190 Issued in NY
Practice address
1 Penn Plaza, 7TH FL. Ste. 725
Evercare
New York, NY 10119
Phone
(212) 216-6465
Fax
(212) 216-6606
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 304190 NY Primary

Addresses

Primary practice location

1 Penn Plaza, 7TH FL. Ste. 725
Evercare
New York, NY 10119

Mailing address

1 Penn Plaza, 7TH FL. Ste. 725
Evercare
New York, NY 10119
Phone (212) 216-6465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY, NJ, NH, ME5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20190524001094 CT Practitioner - Nurse Practitioner 7911220975 Reassigns benefits to 1 organization
I20190614001039 NY Practitioner - Nurse Practitioner 7911220975 Reassigns benefits to 2 organizations
I20220802000413 NJ Practitioner - Nurse Practitioner 7911220975 Reassigns benefits to 1 organization
I20231207000377 NH Practitioner - Nurse Practitioner 7911220975 Reassigns benefits to 1 organization
I20240103000326 ME Practitioner - Nurse Practitioner 7911220975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
71.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Medical PC CurrentSince May 5, 2019 Accepting new patients
Visavis Health Care Medical Group of NH LLC CurrentSince Oct 9, 2023 Accepting new patients
Visavis Health Care Medical Group of NJ LLC CurrentSince Apr 19, 2022 Accepting new patients
New Concept Rehabilitation Medicine PC CurrentSince Mar 1, 2023 Accepting new patients
Visavis Health Care Medical Group of CT LLC CurrentSince May 22, 2023 Accepting new patients
Visavis Health Care Medical Group of Me PLLC CurrentSince Nov 20, 2023 Accepting new patients

Locations

1 Emily Way
West Hartfrd, CT 06107
Phone (860) 561-7022

300 Spring St
Westbrook, ME 04092
Phone (207) 856-1230

20 Maitland St
Concord, NH 03301
Phone (516) 817-7093

1811 Hone Ave
Bronx, NY 10461
Phone (516) 499-9016

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

831 Bedford Ave
Brooklyn, NY 11205

3923 Fort Hamilton Pkwy
Brooklyn, NY 11218
Phone (718) 314-0999

2865 Brighton 3rd St
Brooklyn, NY 11235
Phone (718) 645-1118

1481 McDonald Ave
Fl 2
Brooklyn, NY 11230

7300 State Highway 121
Ste 300
McKinney, TX 75070
Phone (214) 937-0278

7300 State Highway 121
Ste 300374
McKinney, TX 75070

Organizations & group practices 6

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306997291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENN PLAZA, 7TH FL. STE. 725",
            "address_2": "EVERCARE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10119",
            "telephone_number": "212-216-6465",
            "fax_number": "212-216-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLAZA, 7TH FL. STE. 725",
            "address_2": "EVERCARE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10119",
            "telephone_number": "212-216-6465",
            "fax_number": "212-216-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUAN",
        "first_name": "LILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.