Individual provider Active NPI

Raelene Rubillos Ladaga, M.D.

  • Psychiatry Physician
  • Pomona, NY
National Provider Identifier
1467543827
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
225918 Issued in NY
Practice address
978 Route 45 Ste 100
Pomona, NY 10970-3512
Phone
(914) 275-5462
Fax
(845) 675-5067
NPI assigned
Sep 28, 2006
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 225918 NY Primary

Addresses

Primary practice location

978 Route 45 Ste 100
Pomona, NY 10970-3512

Mailing address

978 Route 45 Ste 100
Pomona, NY 10970-3512
Phone (914) 275-5462

Other practice location 1

18 Church St
Nyack, NY 10960-3108
Phone (845) 358-1677 ext. 305

Other identifiers 1

IdentifierTypeStateIssuer
225918OtherNYLICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000156 NY Practitioner - Psychiatry 1355505785 Practice locations: Haverstraw, NY; Nanuet, NY; Pomona, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

22 Cartwright Rd
Stony Point, NY 10980-1726

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raelene Ladaga PastSince Jan 1, 2012 Accepting new patients
Rockland Psychiatric Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rladaga@hiemail.healtheconnections.org

Organizations & group practices 2

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1467543827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 ROUTE 45 STE 100",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703512",
            "telephone_number": "914-275-5462",
            "fax_number": "845-675-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 ROUTE 45 STE 100",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703512",
            "telephone_number": "914-275-5462",
            "fax_number": "845-675-5067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Church St",
            "address_purpose": "LOCATION",
            "city": "Nyack",
            "state": "NY",
            "postal_code": "109603108",
            "country_code": "US",
            "telephone_number": "845-358-1677 x305",
            "fax_number": "845-358-3640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LADAGA",
        "first_name": "RAELENE",
        "middle_name": "RUBILLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "225918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "225918",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

Verify at the official NPI Registry.