Organization Active NPI

Neuropsychiatry PC

  • Psychiatry Physician
  • Port Chester, NY
National Provider Identifier
1407809346
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
204047 Issued in NY
Legal business name
NEUROPSYCHIATRY PC
Practice address
25 S Regent St
Port Chester, NY 10573-3512
Phone
(914) 933-3940
Fax
(914) 840-1281
NPI assigned
May 19, 2006
Last updated
Feb 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Authorized official

Name
Dr. Carlos A Rueda, MDNPI 1366490195
Title
President
Phone
(917) 972-6771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 204047 NY Primary

Addresses

Primary practice location

25 S Regent St
Port Chester, NY 10573-3512

Mailing address

14 Easthaven LN
White Plains, NY 10605-5460
Phone (914) 933-3940

Other practice location 1

60 Essex St
Millburn, NJ 07041-1607
Phone (973) 339-0742

Other practice location 2

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

Other practice location 3

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

Other identifiers 1

IdentifierTypeStateIssuer
02188705MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318001842 NY Part B Supplier - Clinic/Group Practice 5193615490 Receives reassigned benefits from 4 practitioners
Practice locations: Bronx, NY; Yonkers, NY; White Plains, NY; Port Chester, NY

National Provider Directory

National Provider Directory

Locations

1400 Route 70 E
Ste B
Cherry Hill, NJ 08034
Phone (856) 482-0030

60 Essex St
Millburn, NJ 07041
Phone (954) 947-3340

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

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1407809346",
    "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": "914-933-3940",
            "fax_number": "914-840-1281"
        },
        {
            "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": "914-933-3940",
            "fax_number": "914-840-1281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Essex St",
            "address_purpose": "LOCATION",
            "city": "Millburn",
            "state": "NJ",
            "postal_code": "070411607",
            "country_code": "US",
            "telephone_number": "973-339-0742",
            "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": "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"
        }
    ],
    "basic": {
        "organization_name": "NEUROPSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "RUEDA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-972-6771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "204047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02188705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.