NPIMap

Individual provider Active NPI

Tiana Symone Woolridge, MD, MPH

  • Pediatric Sports Medicine Physician
  • New York, NY
National Provider Identifier
1609404185
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
333331 Issued in NY
Practice address
525 E 71St St
New York, NY 10021-4828
Phone
(212) 606-1901
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X 333331 NY Primary

Addresses

Primary practice location

525 E 71St St
New York, NY 10021-4828

Mailing address

525 E 71St St
New York, NY 10021-4828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250109001617 NY Practitioner - Pediatric MedicinePractitioner - Sports Medicine 9537573019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Sports Medicine
Education
University of California, San Francisco School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York Society for the Relief of the Ruptured and Crippled Maintaini 18 clinicians

Practice addresses (Care Compare)

535 E 70TH St
New York, NY 10021-4823
Phone (203) 590-3100

Hospital & facility affiliations

  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Society for the Relief of the Ruptured and Crippled Maintaini CurrentSince Nov 17, 2024 Accepting new patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Jan 1, 2026 Accepting new patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Jan 1, 2026 Accepting new patients
New York Society for the Relief of the Ruptured & Crippled Maintaining PastSince Jan 1, 2020 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

535 E 70th St
#5
New York, NY 10021

535 E 70th St
New York, NY 10021

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

56 Flying Point Rd
Unit 4
Southampton, NY 11968
Phone (631) 377-5900

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1609404185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 71ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 71ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214828",
            "telephone_number": "212-606-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLRIDGE",
        "first_name": "TIANA",
        "middle_name": "SYMONE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NY",
            "license": "333331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.