Individual provider Active NPI

Ryan Marie Cunningham, CPNP

  • Pediatric Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1912258435
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382346 Issued in NY
Practice address
3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone
(718) 920-8278
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382346 NY Primary
Pediatric Registered Nurse 163WP0200X 22 603298 NY

Addresses

Primary practice location

3415 Bainbridge Ave
Bronx, NY 10467-2403

Mailing address

3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone (718) 920-8278

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
I20170110000034 NY Practitioner - Nurse Practitioner 3971884792 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22 603298NYMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 12, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Nov 27, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Nov 27, 2016 Accepting new patients
New York University CurrentSince Jun 12, 2023 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

530 1st Ave
Ste 10N
New York, NY 10016
Phone (212) 263-5858

Networks

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

Interoperability endpoints

  • Direct secure messaging: rcunningham554359@nyumc.direct-ci.com

Organizations & group practices 4

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": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1912258435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-920-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-920-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "RYAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382346",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "22 603298",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.