Active NPI
Ruby Nieves Delamata, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Morgantown, WV
National Provider Identifier
1760577027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 10994
- Practice address
- 1200 J D Anderson Dr
Morgantown, WV 26505-3494 - Phone
- (304) 598-1560
- Fax
- (304) 598-1699
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 10994 | WV | Primary |
Addresses
Primary practice location
1200 J D Anderson Dr
Morgantown, WV 26505-3494
Mailing address
1200 J D Anderson Dr
Morgantown, WV 26505-3494
Phone (304) 598-1560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0103081000 | Medicaid | WV |
Other names 1
- Ruby Nieves Mata
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10994 | WV | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760577027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 J D ANDERSON DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265053494",
"telephone_number": "304-598-1560",
"fax_number": "304-598-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 J D ANDERSON DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265053494",
"telephone_number": "304-598-1560",
"fax_number": "304-598-1699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAMATA",
"first_name": "RUBY",
"middle_name": "NIEVES",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WV",
"license": "10994",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0103081000",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RUBY",
"last_name": "MATA",
"middle_name": "NIEVES",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.