Active NPI
Ruth Scarlet Mendez, NURSE PRATICIONER
- Gerontology Nurse Practitioner
- Brentwood, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 312107
- Practice address
- 128 Charter Oaks Ave
Brentwood, NY 11717-5109 - Phone
- (631) 464-6009
- NPI assigned
- Nov 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 312107 | NY | Primary |
Addresses
Primary practice location
128 Charter Oaks Ave
Brentwood, NY 11717-5109
Mailing address
128 Charter Oaks Ave
Brentwood, NY 11717-5109
Phone (631) 464-6009
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
375 E Main St
Suite 21
Bay Shore, NY 11706-8418
Phone (631) 751-3000
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 312107 | NY | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Hematology Oncology Associates PC | Current | Accepting new patients |
Locations
1377 5th Ave
Bay Shore, NY 11706
Phone (631) 336-7327
3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376
1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354
1 Research Rd
Ridge, NY 11961
48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Organizations & group practices 1
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.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730419200000",
"number": "1427871243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 CHARTER OAKS AVE",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117175109",
"telephone_number": "631-464-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 CHARTER OAKS AVE",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117175109",
"telephone_number": "631-464-6009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ",
"first_name": "RUTH",
"middle_name": "SCARLET",
"credential": "NURSE PRATICIONER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-01",
"last_updated": "2024-11-01",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NY",
"license": "312107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.