Individual provider Active NPI

Jasen Albert Ruiz, SC.D.

  • Audiologist-Hearing Aid Fitter
  • Scarsdale, NY
National Provider Identifier
1467609990
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
57 002140 Issued in NY
Practice address
111 Brook St
Scarsdale, NY 10583-5143
Phone
(914) 395-3277
Fax
(914) 395-3270
NPI assigned
Aug 27, 2008
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 57 002140 NY Primary

Addresses

Primary practice location

111 Brook St
Scarsdale, NY 10583-5143

Mailing address

111 Brook St
Scarsdale, NY 10583-5143
Phone (914) 395-3277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090512000009 NY Practitioner - Qualified Audiologist 1658429121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 Brook St
Scarsdale, NY 10583-5143
Phone (347) 397-7563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002140NYMDMusic Therapist
57 002140NYMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Audiology of Ny PC Audiologist-Hearing Aid Fitter CurrentSince Oct 6, 2010 Accepting new patients
Advanced Audiology of Ny II PC Past Accepting new patients

Locations

400 Aaron Ct
Kingston, NY 12401
Phone (845) 443-3365

390 Crystal Run Rd
Ste 105
Middletown, NY 10941
Phone (845) 703-5523

488 Freedom Plains Rd
Ste 144
Poughkeepsie, NY 12603
Phone (845) 452-7975

111 Brook St
Scarsdale, NY 10583
Phone (347) 397-7563

111 Brook St
Ste 204
Scarsdale, NY 10583

115 Main St
Ste A
Tuckahoe, NY 10707
Phone (914) 395-3277

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": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1467609990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BROOK ST",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835143",
            "telephone_number": "914-395-3277",
            "fax_number": "914-395-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BROOK ST",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835143",
            "telephone_number": "914-395-3277",
            "fax_number": "914-395-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JASEN",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "SC.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-27",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "57 002140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.