Individual provider Active NPI

Rose A Ruddy, ACNP

  • Registered Nurse
  • Pearl River, NY
National Provider Identifier
1629383955
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
485038 Issued in NY
Practice address
262 Blauvelt Rd
Pearl River, NY 10965-2007
Phone
(917) 748-6117
NPI assigned
Aug 11, 2010
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 485038 NY Primary

Addresses

Primary practice location

262 Blauvelt Rd
Pearl River, NY 10965-2007

Mailing address

262 Blauvelt Rd
Pearl River, NY 10965-2007
Phone (917) 748-6117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110317000868 NY Practitioner - Nurse Practitioner 0547443285 Reassigns benefits to 5 organizations
I20200320001888 NJ Practitioner - Nurse Practitioner 0547443285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MSK BergenGroup PAC ID 1456614114, 254 clinicians
MSK HarrisonGroup PAC ID 1052634045, 134 clinicians

Practice addresses (Care Compare)

225 Summit Ave
Montvale, NJ 07645-1523
Phone (908) 542-3336

500 Westchester Ave
West Harrison, NY 10604-3200
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
74.7
Improvement activities
40
Cost
69.14

Merit-based Incentive Payment System (MIPS)

Final score
80.37 of 100Reported as group
Quality
71.5
Improvement activities
40
Cost
70.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
485038NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Urgent Care Group CurrentSince Dec 23, 2010 Accepting new patients
Memorial Medical Consultation Group CurrentSince Jul 7, 2018 Accepting new patients
MSK Harrison CurrentSince Jun 10, 2019 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Feb 12, 2020 Accepting new patients
MSK Bergen CurrentSince Feb 26, 2020 Accepting new patients
Memorial Solid Tumor Group CurrentSince Jul 7, 2018 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Feb 12, 2020 Accepting new patients

Locations

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: rruddy39375@mskcc.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1629383955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 BLAUVELT RD",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652007",
            "telephone_number": "917-748-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 BLAUVELT RD",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652007",
            "telephone_number": "917-748-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDY",
        "first_name": "ROSE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "485038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

Verify at the official NPI Registry.