Individual provider Active NPI

Jonathan Ruan, M.D.

  • Obstetrics & Gynecology Physician
  • Binghamton, NY
National Provider Identifier
1760476329
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
129202 Issued in NY
Practice address
112 Murray St
Binghamton, NY 13905-3707
Phone
(607) 772-8811
Fax
(607) 724-5922
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 129202 NY Primary

Addresses

Primary practice location

112 Murray St
Binghamton, NY 13905-3707

Mailing address

112 Murray St
Binghamton, NY 13905-3707
Phone (607) 772-8811

Other identifiers 1

IdentifierTypeStateIssuer
00421449MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129202NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Donald Werner MD PC Obstetrics & Gynecology CurrentSince Mar 17, 2008 Accepting new patients

Locations

112 Murray St
Binghamton, NY 13905
Phone (607) 772-8811

Organizations & group practices 1

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1760476329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MURRAY ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139053707",
            "telephone_number": "607-772-8811",
            "fax_number": "607-724-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MURRAY ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139053707",
            "telephone_number": "607-772-8811",
            "fax_number": "607-724-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUAN",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "129202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00421449",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.