Individual provider Active NPI

Samantha Lynn Rue, FNP-C

  • Family Nurse Practitioner
  • New Windsor, NY
National Provider Identifier
1508363367
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
324555 Issued in NY
Practice address
92 Old Route 9W Ste 200
New Windsor, NY 12553-5485
Phone
(845) 549-1010
Fax
(845) 565-5027
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 324555 NY Primary

Addresses

Primary practice location

92 Old Route 9W Ste 200
New Windsor, NY 12553-5485

Mailing address

92 Old Route 9W Ste 200
New Windsor, NY 12553-5485
Phone (845) 549-1010

Other practice location 1

1200 State Route 208 Ste 15
Monroe, NY 10950-4649
Phone (845) 549-1010

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
I20180521000223 NY Practitioner - Nurse Practitioner 1951666064 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
324555NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2024 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

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

Organizations & group practices 3

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1508363367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 OLD ROUTE 9W STE 200",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535485",
            "telephone_number": "845-549-1010",
            "fax_number": "845-565-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 OLD ROUTE 9W STE 200",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535485",
            "telephone_number": "845-549-1010",
            "fax_number": "845-565-5027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 State Route 208 Ste 15",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NY",
            "postal_code": "109504649",
            "country_code": "US",
            "telephone_number": "845-549-1010",
            "fax_number": "845-781-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUE",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "324555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

Verify at the official NPI Registry.