Individual provider Active NPI

Adriana Bruges Boude, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1497365183
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1090 Amsterdam Ave FL 16
New York, NY 10025-1737
Phone
(212) 523-5089
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1090 Amsterdam Ave FL 16
New York, NY 10025-1737

Mailing address

1090 Amsterdam Ave FL 16
New York, NY 10025-1737
Phone (212) 523-5089

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
I20260128002457 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 8921586389

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SLR Psychiatric Associates CurrentSince Aug 9, 2020 Accepting new patients
New York General Medical Services PC PastSince Aug 9, 2020 Accepting new patients

Locations

1090 Amsterdam Ave
Fl 16
New York, NY 10025
Phone (212) 523-5089

Interoperability endpoints

  • Direct secure messaging: fjw9005@direct.nyp.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1497365183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE FL 16",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-523-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE FL 16",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-523-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGES BOUDE",
        "first_name": "ADRIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.