Active NPI
Ruth Waldbaum, MD
- Psychiatry Physician
- Manhasset, NY
National Provider Identifier
1952300204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 09662V-1
- Practice address
- 75 Plandome Rd
Manhasset, NY 11030-2301 - Phone
- (516) 365-5136
- Fax
- (516) 365-5137
- NPI assigned
- Jul 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 09662V-1 | NY | Primary |
Addresses
Primary practice location
75 Plandome Rd
Manhasset, NY 11030-2301
Mailing address
75 Plandome Rd
Manhasset, NY 11030-2301
Phone (516) 365-5136
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 354991 | Other | NY | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 1, 2013 through Aug 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09662V-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1952300204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 PLANDOME RD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110302301",
"telephone_number": "516-365-5136",
"fax_number": "516-365-5137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 PLANDOME RD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110302301",
"telephone_number": "516-365-5136",
"fax_number": "516-365-5137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDBAUM",
"first_name": "RUTH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "09662V-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "354991",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.