Individual provider Active NPI

Taslima A Ruma

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1376065763
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F341419 Issued in NY
Practice address
1624 Crosby Ave
Bronx, NY 10461-5201
Phone
(718) 822-2138
Fax
(718) 822-6515
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F341419 NY Primary

Addresses

Primary practice location

1624 Crosby Ave
Bronx, NY 10461-5201

Mailing address

1624 Crosby Ave
Bronx, NY 10461-5201
Phone (718) 822-2138

Other practice location 1

1807 Randall Ave
Bronx, NY 10473-3617
Phone (718) 842-3812

Other identifiers 1

IdentifierTypeStateIssuer
2017000325OtherNYANCC

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
I20180320001171 NY Order and Referring Only - Nurse Practitioner 8123380755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F341419NYMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1376065763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 CROSBY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615201",
            "telephone_number": "718-822-2138",
            "fax_number": "718-822-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 CROSBY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615201",
            "telephone_number": "718-822-2138",
            "fax_number": "718-822-6515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1807 Randall Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104733617",
            "country_code": "US",
            "telephone_number": "718-842-3812",
            "fax_number": "718-822-6515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUMA",
        "first_name": "TASLIMA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F341419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2017000325",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.