Individual provider Active NPI

Carlos Alberto Rueda, MD

  • Geriatric Psychiatry Physician
  • Port Chester, NY
National Provider Identifier
1366490195
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
204047 Issued in NY
Practice address
25 S Regent St
Port Chester, NY 10573-3512
Phone
(917) 972-6771
NPI assigned
May 4, 2006
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 204047 NY Primary
Psychiatry Physician 2084P0800X ME140892 FL

Addresses

Primary practice location

25 S Regent St
Port Chester, NY 10573-3512

Mailing address

14 Easthaven LN
White Plains, NY 10605-5460
Phone (917) 972-6771

Other practice location 1

25 Pompton Ave
suite 308
Verona, NJ 07044
Phone (608) 313-7083

Other practice location 2

7301A W Palmetto Park Rd Ste 307C
Boca Raton, FL 33433-3409
Phone (561) 705-0253

Other practice location 3

976 Lake Baldwin Ln Ste 102
Orlando, FL 32814-6687
Phone (407) 753-4615

Other practice location 4

635 Primera Blvd Ste 121
Lake Mary, FL 32746-2173
Phone (407) 720-6486

Other practice location 5

1210 E Osceola Pkwy Ste 203&204
Kissimmee, FL 34744-1621
Phone (407) 961-6602

Other practice location 6

1950 Route 70 E Ste 201
Cherry Hill, NJ 08003-2128
Phone (856) 229-0138

Other practice location 7

151 Fries Mill Rd Ste 101
Turnersville, NJ 08012-2056
Phone (856) 229-0138

Other practice location 8

310 Central Ave Ste 105
East Orange, NJ 07018-2838
Phone (862) 658-7190

Other practice location 9

1423 Tilton Rd Ste 6
Northfield, NJ 08225-1857
Phone (609) 697-7933

Other practice location 10

1400 Route 70 E Fl 2
Cherry Hill, NJ 08034-2240
Phone (856) 475-6497

Other practice location 11

45 Essex St Ste 200
Millburn, NJ 07041-1668
Phone (973) 840-8517

Other practice location 12

240 Frisch Ct Ste 105
Paramus, NJ 07652-5249
Phone (551) 230-2425

Other practice location 13

25 Pompton Ave Ste 308
Verona, NJ 07044-2939
Phone (608) 352-4265

Other practice location 14

240 Frisch Ct Ste 101
Paramus, NJ 07652-5249
Phone (201) 472-5448

Other practice location 15

60 Essex Street
Millburn, NJ 07041
Phone (973) 339-0742

Other practice location 16

1890 W County Road 419 Ste 1020
Oviedo, FL 32765-4402
Phone (407) 720-6536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, FL, CT4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20040529000062 NY Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 6103807607 Reassigns benefits to 2 organizations
I20160701000920 NJ Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 6103807607 Reassigns benefits to 3 organizations
I20191121000822 FL Practitioner - Psychiatry 6103807607 Reassigns benefits to 1 organization
I20200413000729 CT Practitioner - Psychiatry 6103807607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Healthcare IncGroup PAC ID 9739171984, 21 clinicians

Practice addresses (Care Compare)

220 Hamburg Tpke
Suite 4
Wayne, NJ 07470-2132
Phone (973) 389-6022

251 Grandview Blvd
Yonkers, NY 10710-2508
Phone (203) 901-2493

621 Main St
Paterson, NJ 07503-3028
Phone (973) 754-4750

641 Main St
Paterson, NJ 07503-3028
Phone (973) 754-4750

645 Main St
Paterson, NJ 07503-3028
Phone (973) 754-2805

703 Main St
Paterson, NJ 07503-2621

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Family Health NP PC Current Accepting new patients
St Josephs Medical Group PC CurrentSince Nov 2, 2021 Accepting new patients
St. Joseph's Healthcare, Inc. CurrentSince Apr 9, 2016 Accepting new patients
Vital Healthcare Solutions Psychiatry CurrentSince Dec 1, 2021 Accepting new patients
Success TMS Professional Services New Jersey LLC Psychiatry CurrentSince Nov 1, 2021 Accepting new patients
TMS Professional Services of New Jersey, LLC Psychiatry PastSince Oct 27, 2019 Accepting new patients
Neuropsychiatry Consultants LLP Psychiatry Past Accepting new patients
The Carson Center Past Accepting new patients
Medical Healthcare Services P.C. Psychiatry PastSince Jan 1, 2012 Accepting new patients
Psychiatry and Psychotherapy Practice P.C. Psychiatry PastSince Mar 1, 2007 Accepting new patients

Locations (25 of 26)

1615 S Congress Ave
Ste 200
Delray Beach, FL 33445

1555 Palm Beach Lakes Blvd
Ste 1105
West Palm Beach, FL 33401

1400 Route 70 E
Fl 2
Cherry Hill, NJ 08034
Phone (856) 427-4336

1950 Route 70 E
Ste 201
Cherry Hill, NJ 08003
Phone (856) 229-0138

240 Central Ave
East Orange, NJ 07018
Phone (973) 414-3473

310 Central Ave
Ste 105
East Orange, NJ 07018
Phone (862) 658-7190

30 Two Bridges Rd
Ste 205
Fairfield, NJ 07004

34 Manchester Ave
Ste 202
Forked River, NJ 08731

303 W Main St
Ste 350
Freehold, NJ 07728
Phone (732) 308-4400

1 University Plz
Ste 408
Hackensack, NJ 07601

517 Route 1 S
Ste 1109
Iselin, NJ 08830
Phone (732) 896-9847

45 Essex St
Ste 200
Millburn, NJ 07041
Phone (973) 840-8517

1423 Tilton Rd
Ste 6
Northfield, NJ 08225
Phone (609) 697-7933

240 Frisch Ct
Ste 101
Paramus, NJ 07652
Phone (201) 470-5709

240 Frisch Ct
Ste 105
Paramus, NJ 07652
Phone (551) 230-2425

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

1000 Herrontown Rd
Ste 100
Princeton, NJ 08540
Phone (609) 337-2369

405 Hurffvle CR Keys Rd
Ste 202
Sewell, NJ 08080
Phone (856) 566-7093

106 Apple St
Ste 106
Tinton Falls, NJ 07724
Phone (732) 784-3679

151 Fries Mill Rd
Ste 101
Turnersville, NJ 08012
Phone (201) 377-0880

415 W Landis Ave
Ste 102
Vineland, NJ 08360
Phone (609) 653-9110

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

37 N Chemung St
Waverly, NY 14892
Phone (607) 565-2861

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: crueda@sjhbh.cernerdirect.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1366490195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 EASTHAVEN LN",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055460",
            "telephone_number": "917-972-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S REGENT ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733512",
            "telephone_number": "917-972-6771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Pompton Ave",
            "address_2": "suite 308",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "07044",
            "country_code": "US",
            "telephone_number": "608-313-7083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7301A W Palmetto Park Rd Ste 307C",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334333409",
            "country_code": "US",
            "telephone_number": "561-705-0253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "976 Lake Baldwin Ln Ste 102",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328146687",
            "country_code": "US",
            "telephone_number": "407-753-4615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 Primera Blvd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327462173",
            "country_code": "US",
            "telephone_number": "407-720-6486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 E Osceola Pkwy Ste 203&204",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347441621",
            "country_code": "US",
            "telephone_number": "407-961-6602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 Route 70 E Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032128",
            "country_code": "US",
            "telephone_number": "856-229-0138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "151 Fries Mill Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122056",
            "country_code": "US",
            "telephone_number": "856-229-0138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 Central Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070182838",
            "country_code": "US",
            "telephone_number": "862-658-7190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1423 Tilton Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "NJ",
            "postal_code": "082251857",
            "country_code": "US",
            "telephone_number": "609-697-7933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Route 70 E Fl 2",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342240",
            "country_code": "US",
            "telephone_number": "856-475-6497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Essex St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Millburn",
            "state": "NJ",
            "postal_code": "070411668",
            "country_code": "US",
            "telephone_number": "973-840-8517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Frisch Ct Ste 105",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076525249",
            "country_code": "US",
            "telephone_number": "551-230-2425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Pompton Ave Ste 308",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070442939",
            "country_code": "US",
            "telephone_number": "608-352-4265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Frisch Ct Ste 101",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076525249",
            "country_code": "US",
            "telephone_number": "201-472-5448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Essex Street",
            "address_purpose": "LOCATION",
            "city": "Millburn",
            "state": "NJ",
            "postal_code": "07041",
            "country_code": "US",
            "telephone_number": "973-339-0742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 W County Road 419 Ste 1020",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327654402",
            "country_code": "US",
            "telephone_number": "407-720-6536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUEDA",
        "first_name": "CARLOS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "204047",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME140892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.