Individual provider Active NPI

Sophia Ruman, PA

  • Surgical Physician Assistant
  • Syracuse, NY
National Provider Identifier
1780754366
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
011405-1 Issued in NY
Practice address
301 Prospect Ave
Surgical PA Office Room 4202
Syracuse, NY 13203-1807
Phone
(315) 448-2876
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 011405-1 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Surgical PA Office Room 4202
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Surgical PA Office Room 4202
Syracuse, NY 13203-1807
Phone (315) 448-2876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070919000843 NY Practitioner - Physician Assistant 1254425309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

15 Maple Ave
Warwick, NY 10990-1028
Phone (845) 986-2276

20 Grand St
FL 3
Warwick, NY 10990-1035
Phone (845) 987-3906

Hospital & facility affiliations

  • Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135
  • St Anthony Community Hospital Hospital, Warwick, NY, CCN 330205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011405NYMDClinical Child & Adolescent Psychologist
011405-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Medical PC Current Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

Networks

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

Organizations & group practices 3

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 2

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1780754366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "SURGICAL PA OFFICE ROOM 4202",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "SURGICAL PA OFFICE ROOM 4202",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMAN",
        "first_name": "SOPHIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011405-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.