Individual provider Active NPI

Angie Rumaldo, PH.D, PMH-NP

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1891018263
Registry record updated Jul 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018514 Issued in NY
Practice address
530 W 236TH St
Suite 1K
Bronx, NY 10463-1748
Phone
(718) 701-5833
Fax
(888) 635-6499
NPI assigned
Mar 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018514 NY
Clinical Psychologist 103TC0700X 018514 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 018514 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402055-1 NY

Addresses

Primary practice location

530 W 236TH St
Suite 1K
Bronx, NY 10463-1748

Mailing address

530 W 236TH St
Suite 1K
Bronx, NY 10463-1748
Phone (718) 701-5833

Other identifiers 1

IdentifierTypeStateIssuer
03216259MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000266 NY Practitioner - Clinical Psychologist 6901937457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2860 Bailey Ave
Apt 1a
Bronx, NY 10463-7227
Phone (718) 701-5833

700 W 180TH St
Apt 4
New York, NY 10033-5619
Phone (718) 701-5833

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F402055-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True Pursuit Psychological Services PC Clinical CurrentSince Mar 9, 2012 Accepting new patients

Locations

2860 Bailey Ave
Apt 1A
Bronx, NY 10463
Phone (718) 701-5833

700 W 180th St
Apt 4
New York, NY 10033
Phone (212) 781-6590

Networks

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

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": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469836800000",
    "number": "1891018263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W 236TH ST",
            "address_2": "SUITE 1K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631748",
            "telephone_number": "718-701-5833",
            "fax_number": "888-635-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W 236TH ST",
            "address_2": "SUITE 1K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631748",
            "telephone_number": "718-701-5833",
            "fax_number": "888-635-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMALDO",
        "first_name": "ANGIE",
        "name_prefix": "Dr.",
        "credential": "PH.D, PMH-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2016-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018514",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018514",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "018514",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402055-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03216259",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.