Individual provider Active NPI

Ruth Yeboah

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1477188167
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
627976 Issued in NY
Practice address
1191 Clay Ave Apt BB
Bronx, NY 10456-4230
Phone
(917) 790-9134
NPI assigned
Mar 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 627976 NY Primary

Addresses

Primary practice location

1191 Clay Ave Apt BB
Bronx, NY 10456-4230

Mailing address

1191 Clay Ave Apt BB
Bronx, NY 10456-4230
Phone (917) 790-9134

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220509000181 NY Practitioner - Nurse Practitioner 5496132763 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
E and a Medical Solutions LLCGroup PAC ID 5092969618, 13 clinicians

Practice addresses (Care Compare)

253 E 142ND St
Bronx, NY 10451-5906

51 E 125TH St
FRNT 2
New York, NY 10035-1687
Phone (646) 585-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
627976NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siuc Medical PC CurrentSince Jun 1, 2022 Accepting new patients
E & a Medical Solutions LLC CurrentSince Jul 1, 2025 Accepting new patients
Tristate Physician Services PC CurrentSince Oct 24, 2024 Accepting new patients
1211 WPR Medical Services PC CurrentSince May 1, 2022 Accepting new patients

Locations

326 E 149th St
Bronx, NY 10451
Phone (718) 585-6100

1211 White Plains Rd
Bronx, NY 10472
Phone (718) 409-1338

51 E 125th St
Frnt 2
New York, NY 10035
Phone (646) 585-1515

153 W 27th St
Ste 1100
New York, NY 10001
Phone (833) 947-4927

500 Fashion Ave
New York, NY 10018
Phone (212) 642-3451

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ruth.yeboah.1@24989.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1477188167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 CLAY AVE APT BB",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564230",
            "telephone_number": "917-790-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 CLAY AVE APT BB",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564230",
            "telephone_number": "917-790-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEBOAH",
        "first_name": "RUTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "627976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.