Individual provider Active NPI

Steve Teni Ayanruoh

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1942264510
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200169-1 Issued in NY
Practice address
104 Vermilyea Ave FRNT B1
New York, NY 10034-3209
Phone
(212) 544-8854
Fax
(212) 544-8867
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200169-1 NY Primary

Addresses

Primary practice location

104 Vermilyea Ave FRNT B1
New York, NY 10034-3209

Mailing address

104 Vermilyea Ave FRNT B1
New York, NY 10034-3209
Phone (212) 544-8854

Other identifiers 1

IdentifierTypeStateIssuer
01621278MedicaidNY

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
I20081018000127 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2961560081 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 Vermilyea Ave
FRNT B1
New York, NY 10034-3209
Phone (212) 544-8854

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200169-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Group PC CurrentSince Mar 14, 2009 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Feb 4, 2024 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Aug 5, 2024 Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

104 Vermilyea Ave
Frnt B1
New York, NY 10034
Phone (212) 544-8854

104 Vermilyea Ave
Ste B
New York, NY 10034
Phone (212) 544-8854

Networks

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

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1942264510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 VERMILYEA AVE FRNT B1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343209",
            "telephone_number": "212-544-8854",
            "fax_number": "212-544-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 VERMILYEA AVE FRNT B1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343209",
            "telephone_number": "212-544-8854",
            "fax_number": "212-544-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYANRUOH",
        "first_name": "STEVE",
        "middle_name": "TENI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "200169-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01621278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.