Individual provider Active NPI

Sara Jean Ruddy, PA-C

  • Medical Physician Assistant
  • Hartford, CT
National Provider Identifier
1376630731
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003327 Issued in CT
Practice address
80 Seymour Street
Hartford Hospital Emergency Medicine
Hartford, CT 06102-5037
Phone
(860) 972-0000
NPI assigned
Oct 6, 2006
Last updated
Jul 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052698 PA
Physician Assistant 363A00000X 003327 CT
Medical Physician Assistant 363AM0700X 003327 CT Primary
Surgical Physician Assistant 363AS0400X 003327 CT

Addresses

Primary practice location

80 Seymour Street
Hartford Hospital Emergency Medicine
Hartford, CT 06102-5037

Mailing address

80 Seymour Street
Hartford Hosptial Emergency Medicine
Hartfod, CO 06102-5037
Phone (860) 972-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20151026001399 CT Practitioner - Physician Assistant 1456358241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3327CTMDMarriage & Family Therapist
003327CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Sep 1, 2015 Accepting new patients
Hartford Hospital CurrentSince Sep 1, 2015 Accepting new patients
Old City Emergency Physicians Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437177600000",
    "number": "1376630731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPTIAL EMERGENCY MEDICINE",
            "city": "HARTFOD",
            "state": "CO",
            "postal_code": "061025037",
            "telephone_number": "860-972-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL EMERGENCY MEDICINE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDY",
        "first_name": "SARA",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052698",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003327",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003327",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.