NPIMap

Organization Active NPI

Excel Urgent Care of Goshen PLLC

  • Urgent Care Clinic/Center
  • Goshen, NY
National Provider Identifier
1710132816
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
EXCEL URGENT CARE OF GOSHEN PLLC
Practice address
1 Hatfield LN Ste 2B
Goshen, NY 10924-6753
Phone
(845) 565-3700
Fax
(845) 565-3395
NPI assigned
Nov 18, 2008
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Dr. Anthony R Ruvo, MDNPI 1972628014
Title
President
Phone
(845) 565-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1 Hatfield LN Ste 2B
Goshen, NY 10924-6753

Mailing address

1 Hatfield LN
Goshen, NY 10924-6752
Phone (845) 565-3700

Other identifiers 1

IdentifierTypeStateIssuer
03825490MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090303000266 NY Part B Supplier - Clinic/Group Practice 5496811275 Receives reassigned benefits from 48 practitioners
Practice locations: Goshen, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1091756Excel Urgent Care of Goshen PLLC1 Hatfield Lane, Goshen, NY 10924Certificate of waiverNov 9, 2026

National Provider Directory

National Provider Directory

Locations

1 Hatfield Ln
Goshen, NY 10924
Phone (845) 294-5128

1 Hatfield Ln
Ste 2B
Goshen, NY 10924
Phone (845) 360-5530

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1710132816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HATFIELD LN",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246752",
            "telephone_number": "845-565-3700",
            "fax_number": "845-565-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HATFIELD LN STE 2B",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246753",
            "telephone_number": "845-565-3700",
            "fax_number": "845-565-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL URGENT CARE OF GOSHEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "RUVO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-565-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03825490",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.