Individual provider Active NPI

Ruben Olmedo, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1831164680
Registry record updated Jul 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
203456 1 Issued in NY
Practice address
1 Gustave L Levy PL FL 12
New York, NY 10029-6574
Phone
(917) 595-9920
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 27804 NY
Emergency Medicine Physician 207P00000X 203456 1 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL FL 12
New York, NY 10029-6574

Mailing address

Box 1149
One Gustave Levy Place
New York, NY 10029
Phone (212) 241-0101

Other practice location 1

100th Street and Madison Avenue
New York, NY 10029
Phone (212) 241-0101

Other identifiers 2

IdentifierTypeStateIssuer
930099986OtherNYRR MEDICARE
01704576MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070301000262 NY Practitioner - Emergency Medicine 4486756921 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 6103251491, 50 clinicians

Practice addresses (Care Compare)

1468 Madison Ave
New York, NY 10029-6508
Phone (212) 987-3100

234 E 85TH St
New York, NY 10028-3001
Phone (646) 605-5669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203456 1NYMDEmergency Medicine Physician
27804NYMDMedical Toxicology (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Emergency Medicine CurrentSince May 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Mar 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based CurrentSince May 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Nov 25, 2022 Accepting new patients
Mount Sinai School of Medicine Emergency Medicine Past Accepting new patients
Montefiore Medical Center Emergency Medicine Past Accepting new patients

Locations

7901 Broadway
Rm A19
Elmhurst, NY 11373
Phone (718) 334-3380

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

Networks

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

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658534400000",
    "number": "1831164680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 1149",
            "address_2": "ONE GUSTAVE LEVY PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-0101",
            "fax_number": "212-426-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "917-595-9920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100th Street and Madison Avenue",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "212-241-0101",
            "fax_number": "212-426-5083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLMEDO",
        "first_name": "RUBEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "NY",
            "license": "27804",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "203456 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "930099986",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01704576",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.